Case Report
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Chest pain in a patient with polyarteritis nodosa and Behcet's disease; myocardial infarction or aortic dissection?

Year 2021, Volume: 3 Issue: 3, 141 - 144, 29.07.2021
https://doi.org/10.46310/tjim.854261

Abstract

Aortic diseases have high mortality and are usually late or misdiagnosed. Especially in patients with inflammatory vasculitis, diagnosis is often confused with other causes of chest pain and this causes a delay in diagnosis. Vascular complications are the most important predictors of mortality and morbidity in Behcet’s disease and also polyarteritis nodosa. The diagnosis of aortitis is usually obtained by vascular imaging, but partly made only by biopsy on occasion of an operation. Here we present a case of pathologically proven fatal aortitis and aortic dissection in a patient with Polyarteritis nodosa and Behcet's disease.

References

  • Koc Y, Gullu I, Akpek G, Akpolat T, Kansu E, Kiraz S, et al. Vascular involvement in Behcet’s disease. J Rheumatol 1992;19:402–10.
  • Lie JT. Vascular involvement in Behcet’s disease: arterial and venous and vessels of all sizes. J Rheumatol 1992;19:341–3.
  • Bletry O, Motattane A, Wechsler B, et al. Cardiac manifestations of Behc¸et’s disease: twelve cases. Presse Med 1998;17:2388.
  • Bowles C, Nelson A, Hammill S, et al. Cardiac involvement in Behcet’s disease. Arthritis Rheum 1985;28:345.
  • Cid MC, Grau JM, Casademont J, Campo E, Coll-Vinent B, López-Soto A, et al. Immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa. Arthritis Rheum 1994;37:1055–61.
  • De Virgilio A, Greco A, Magliulo G, Gallo A, Ruoppolo G, Conte M, Martellucci S, de Vincentiis M. Polyarteritis nodosa: a contemporary overview. Autoimmunity reviews. 2016 Jun 1;15(6):564-70.
  • McWilliams ET, Khonizy W, Jameel A et al. Polyarteritis nodosa presenting as acute myocardial infarction in a young man: importance of invasive angiography.
  • Keith H. Chu,1 MD, Frank J. Menapace,1* MD, James C. Blankenship,1 MD, Ray Hausch,2 MD, and Thomas Harrington,2 MD et al. .Polyarteritis Nodosa Presenting as Acute Myocardial Infarction With Coronary Dissection.
  • Iino T, Eguchi K, Sakai M, Nagataki S, Ishijima M, Toriyama K. et al Polyarteritis nodosa with aortic dissection: necrotizing vasculitis of the vasa vasorum.
  • Caspary L. Inflammatory diseases of the aorta. Vasa. 2016 Jan 1;45(1):17-29.
  • Gornik HL, Creager MA. Aortitis. Circulation. 2008 Jun 10;117(23):3039-51.
Year 2021, Volume: 3 Issue: 3, 141 - 144, 29.07.2021
https://doi.org/10.46310/tjim.854261

Abstract

References

  • Koc Y, Gullu I, Akpek G, Akpolat T, Kansu E, Kiraz S, et al. Vascular involvement in Behcet’s disease. J Rheumatol 1992;19:402–10.
  • Lie JT. Vascular involvement in Behcet’s disease: arterial and venous and vessels of all sizes. J Rheumatol 1992;19:341–3.
  • Bletry O, Motattane A, Wechsler B, et al. Cardiac manifestations of Behc¸et’s disease: twelve cases. Presse Med 1998;17:2388.
  • Bowles C, Nelson A, Hammill S, et al. Cardiac involvement in Behcet’s disease. Arthritis Rheum 1985;28:345.
  • Cid MC, Grau JM, Casademont J, Campo E, Coll-Vinent B, López-Soto A, et al. Immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa. Arthritis Rheum 1994;37:1055–61.
  • De Virgilio A, Greco A, Magliulo G, Gallo A, Ruoppolo G, Conte M, Martellucci S, de Vincentiis M. Polyarteritis nodosa: a contemporary overview. Autoimmunity reviews. 2016 Jun 1;15(6):564-70.
  • McWilliams ET, Khonizy W, Jameel A et al. Polyarteritis nodosa presenting as acute myocardial infarction in a young man: importance of invasive angiography.
  • Keith H. Chu,1 MD, Frank J. Menapace,1* MD, James C. Blankenship,1 MD, Ray Hausch,2 MD, and Thomas Harrington,2 MD et al. .Polyarteritis Nodosa Presenting as Acute Myocardial Infarction With Coronary Dissection.
  • Iino T, Eguchi K, Sakai M, Nagataki S, Ishijima M, Toriyama K. et al Polyarteritis nodosa with aortic dissection: necrotizing vasculitis of the vasa vasorum.
  • Caspary L. Inflammatory diseases of the aorta. Vasa. 2016 Jan 1;45(1):17-29.
  • Gornik HL, Creager MA. Aortitis. Circulation. 2008 Jun 10;117(23):3039-51.
There are 11 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

Serkan Asıl 0000-0002-6782-4237

Hatice Taşkan 0000-0001-8309-6076

Ender Murat 0000-0002-0147-5476

Selen Eşki 0000-0002-2737-0349

Uygar Çağdaş Yüksel 0000-0003-1531-6967

Publication Date July 29, 2021
Submission Date January 5, 2021
Acceptance Date February 28, 2021
Published in Issue Year 2021 Volume: 3 Issue: 3

Cite

EndNote Asıl S, Taşkan H, Murat E, Eşki S, Yüksel UÇ (July 1, 2021) Chest pain in a patient with polyarteritis nodosa and Behcet’s disease; myocardial infarction or aortic dissection?. Turkish Journal of Internal Medicine 3 3 141–144.

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