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Fever of unknown origin, giant cell arteritis, and aortic dissection

Fieber unbekannter Genese, Riesenzellarteriitis und Aortendissektion

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Abstract

Giant cell arteritis is one of the most frequent causes of pyrexia of unknown origin after infectious or malignant causes have been ruled out. In this case report we describe a 66-year old female patient, who after five weeks of remitting fever developed a life-threatening, painless severe aortic dissection. The timely use of modern imaging technologies such as magnetic resonance angiography or positron emission computed tomography could in the future be of help to recognize aortic involvement early and to avoid this devastating complication in patients with fever of unknown origin.

Zusammenfassung

Die Riesenzellarteriitis ist nach dem Ausschluss infektiöser oder maligner Grunderkrankungen eine der häufigsten Ursachen von Fieber unklarer Genese. Dieser Fallbericht beschreibt eine 66-jährige Patientin, die nach mit fünf Wochen mit remittierendem Fieber eine schmerzlose Aortendissektion entwickelte. Der rechtzeitige Einsatz moderner bildgebender Verfahren wie Magnetresonanz-angiographie oder Positronenemissions-Computertomographie kann in Zukunft dazu beitragen,  bei Patienten mit Fieber unklarer Genese eine aortale Beteiligung früher zu erkennen und lebensbedrohliche Komplikationen zu verhindern.

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Authors and Affiliations

  1. Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany

    K. Hofheinz, J. Wacker, G. Schett &  B. Manger

  2. Institute for Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany

    S. Bertz

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  1. K. Hofheinz
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  2. S. Bertz
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  3. J. Wacker
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  4. G. Schett
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  5. B. Manger
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Correspondence to B. Manger.

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Conflict of interest

K. Hofheinz, S. Bertz, J. Wacker, G. Schett, and B. Manger declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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E. Reinhold-Keller, Hamburg

F. Moosig, Neumünster

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Hofheinz, K., Bertz, S., Wacker, J. et al. Fever of unknown origin, giant cell arteritis, and aortic dissection. Z Rheumatol 76, 83–86 (2017). https://doi.org/10.1007/s00393-016-0245-5

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  • DOI: https://doi.org/10.1007/s00393-016-0245-5

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