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[大动脉炎的鉴别诊断]

[Differential diagnosis of aortitis].

作者信息

Rousselin C, Pontana F, Puech P, Lambert M

机构信息

Faculté de médecine Henri-Warembourg, université Lille 2, Lille, France; Service de médecine interne, centre national de référence des maladies autoimmunes et systémiques rares, hôpital Claude-Huriez, CHRU de Lille, 59037 Lille cedex, France.

Faculté de médecine Henri-Warembourg, université Lille 2, Lille, France; Service d'imagerie cardiovasculaire, hôpital cardiologique, CHRU de Lille, Lille, France.

出版信息

Rev Med Interne. 2016 Apr;37(4):256-63. doi: 10.1016/j.revmed.2016.02.002. Epub 2016 Mar 3.

Abstract

Aortitis are mainly described in inflammatory disorders such as Takayasu arteritis, giant cell arteritis or Behçet's disease. Aortitis is sometimes qualified as idiopathic. However, differential diagnoses must be searched since they need specific interventions. Infectious aortitis should be ruled out first as its rapid evolution and short-term poor prognosis makes it a therapeutic emergency. Furthermore, rarer differential diagnoses should be known as they require specific care that might sometimes differ from the treatment of inflammatory aortitis, such as retroperitoneal fibrosis mostly idiopathic but also secondary to neoplasia or malignant hemopathies. IgG4 related disease, Erdheim-Chester disease and inflammatory abdominal aortic aneurysm due to atherosclerosis are other differential diagnoses to mention in the presence of aortitis in order to adapt patients' care consequently.

摘要

主动脉炎主要见于诸如大动脉炎、巨细胞动脉炎或白塞病等炎症性疾病。主动脉炎有时被认为是特发性的。然而,必须进行鉴别诊断,因为它们需要特定的干预措施。首先应排除感染性主动脉炎,因为其病情进展迅速且短期预后较差,使其成为治疗急症。此外,应了解更罕见的鉴别诊断,因为它们需要特定的治疗,有时可能与炎症性主动脉炎的治疗不同,例如大多数为特发性但也继发于肿瘤或恶性血液病的腹膜后纤维化。IgG4相关疾病、 Erdheim-Chester病以及动脉粥样硬化所致的炎性腹主动脉瘤也是在出现主动脉炎时需要提及的其他鉴别诊断,以便相应地调整患者的治疗。

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