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Early recognition of aortitis of the aorta ascendens with 18F-FDG PET/CT: syphilitic?

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Abstract

We present the case of a 42-year-old woman known with a human leukocyte antigen B27 positive ankylosing spondylitis. Despite treatment with a tumor necrosis factor blocking agent, the patient was not pain free and inflammation markers remained elevated. An 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was performed in an attempt to exclude possible other inflammatory processes. The 18F-FDG PET/CT revealed increased metabolic activity in the ascending aortic wall, which appeared unexpectedly related to late syphilis. Based on this case and existing literature on this subject, we come to the conclusion that 18F-FDG PET/CT can help in an early establishment of syphilitic aortitis before the possible life-threatening sequelae of syphilitic aortitis occur.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Medical Center Leeuwarden, P.O. Box 850, 8901 BR, Leeuwarden, The Netherlands

    H. Balink

  2. Department of Rheumatology, Medical Center Leeuwarden, Leeuwarden, The Netherlands

    A. Spoorenberg & P. M. Houtman

  3. Izore Center for Infection and Immunity Friesland, Leeuwarden, The Netherlands

    A. Brandenburg

  4. Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    H. J. Verberne

Authors
  1. H. Balink
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  2. A. Spoorenberg
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  3. P. M. Houtman
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  4. A. Brandenburg
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  5. H. J. Verberne
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Corresponding author

Correspondence to H. Balink.

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Balink, H., Spoorenberg, A., Houtman, P.M. et al. Early recognition of aortitis of the aorta ascendens with 18F-FDG PET/CT: syphilitic?. Clin Rheumatol 32, 705–709 (2013). https://doi.org/10.1007/s10067-013-2178-6

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  • DOI: https://doi.org/10.1007/s10067-013-2178-6

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