title: Early recognition of aortitis of the aorta ascendens with ¹⁸F-FDG PET/CT: syphilitic?
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 (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) was performed in an attempt to exclude possible other inflammatory processes. The (18)F-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 (18)F-FDG PET/CT can help in an early establishment of syphilitic aortitis before the possible life-threatening sequelae of syphilitic aortitis occur.
authors: Department of Nuclear Medicine, Medical Center Leeuwarden, PO Box 850, 8901 BR Leeuwarden, The Netherlands. hans.balink@znb.nl
authors: H
authors: H
authors: Balink
authors: A
authors: A
authors: Spoorenberg
authors: P M
authors: PM
authors: Houtman
authors: A
authors: A
authors: Brandenburg
authors: H J
authors: HJ
authors: Verberne
mesh_terms: D000328:Adult; D001011:Aorta / Q000473:pathology*; D001025:Aortitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D015796:HLA-B27 Antigen / Q000096:biosynthesis; D006801:Humans; D007249:Inflammation; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000378:metabolism; D013589:Syphilis, Cardiovascular / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D015796:HLA-B27 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
references: J Rheumatol. 1994 Dec;21(12):2286-91
references: 7699630
references: Vasc Med. 2011 Oct;16(5):360-4
references: 21844068
references: Am J Cardiol. 2009 Dec 1;104(11):1578-87
references: 19932796
references: Arthritis Rheum. 2000 Apr;43(4):901-7
references: 10765937
references: J Chronic Dis. 1955 Sep;2(3):311-44
references: 13252075
references: Arthritis Rheum. 1990 Feb;33(2):160-72
references: 2306288
references: J Nucl Med. 2005 Aug;46(8):1278-84
references: 16085583
references: Joint Bone Spine. 2011 Oct;78(5):451-5
references: 21185758
references: Int J STD AIDS. 2009 May;20(5):300-9
references: 19386965
references: Circulation. 1964 Mar;29:346-55
references: 14128825
references: Arch Intern Med. 1964 Dec;114:792-8
references: 14211593
references: Rev Bras Cir Cardiovasc. 2010 Jul-Sep;25(3):415-8
references: 21103753
references: Infection. 2005 Oct;33(5-6):387-9
references: 16258874
references: Am J Med. 1989 Oct;87(4):425-33
references: 2679075
references: Clin Rheumatol. 2007 Dec;26(12):2177-2179
references: 17636364
references: Indian J Pathol Microbiol. 2010 Oct-Dec;53(4):624-7
references: 21045381
references: Ann Thorac Surg. 2011 Oct;92(4):1503-6
references: 21958803
references: Pathology. 2006 Aug;38(4):302-8
references: 16916717
references: Int J Cardiovasc Imaging. 2011 Jun;27(5):695-9
references: 21505957
references: Clin Rheumatol. 2012 May;31(5):861-71
references: 22322206
references: J Am Coll Cardiol. 2012 Jan 3;59(1):e1
references: 22192679
references: Int J STD AIDS. 1995 Jul-Aug;6(4):241-8
references: 7548285
references: Rheumatology (Oxford). 2010 Apr;49(4):829
references: 20129996