Lesson of the month: Large vessel vasculitis: A rare cause of transaminitis.

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-03-29 DOI:10.1016/j.clinme.2024.100035
Sumaya Hussein, Greg Allister, Azeem Ahmed
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Abstract

We present the case of a 73-year-old male with pyrexia of unknown origin (PUO). He was a returned traveller from Southern Africa and underwent extensive investigation to rule out an infective cause. This was mostly unrevealing but there was a notable transaminitis (ALT predominant) with normal bilirubin level. He showed no serological or clinical improvement despite antibiotic treatment. Subsequent CT-PET showed high mural uptake in the thoracic and abdominal aorta and its major branches, confirming the diagnosis of Large Vessel Vasculitis (LVV). This case highlights the importance of considering LVV in patients with PUO and with transaminitis.

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本月课程大血管炎:转氨酶炎的罕见病因。
我们介绍了一例不明原因热病(PUO)的 73 岁男性病例。他从南部非洲旅行归来,接受了广泛的检查以排除感染原因。检查结果大多没有发现感染原因,但出现了明显的转氨酶炎(以谷丙转氨酶为主),胆红素水平正常。尽管接受了抗生素治疗,但血清学和临床症状均无改善。随后的 CT-PET 显示,胸腹主动脉及其主要分支的壁层摄取较高,确诊为大血管炎(LVV)。该病例强调了考虑PUO和转氨酶炎患者大血管炎的重要性。
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来源期刊
Clinical Medicine
Clinical Medicine 医学-医学:内科
CiteScore
7.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year
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