Baymakova M, Demirev A, Kostadinova I, Andonova R, Popov G T, Plochev K
Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria.
Department of Nuclear Medicine, University Hospital Acibadem City Clinic Cancer Center, Sofia, Bulgaria.
Clin Ter. 2018 Nov-Dec;169(6):e274-e276. doi: 10.7417/CT.2018.2092.
We present a case of 68-year-old female with four months history of fever, fatigue, and weight loss. She was classified as case of fever of unknown origin. The physical examination was normal, the laboratory tests showed anemia, elevation of C-reactive protein, erythrocyte sedimentation rate and fibrinogen. The diagnosis was unclear and 18F-FDG PET/CT was performed. Images showed high glucose uptake in the wall of the ascending and descending aorta, in the walls of the subclavian arteries, abdominal aorta and proximal part of both iliac arteries. The diagnosis of GCA appeared most likely and steroid treatment was initiated. After the therapy, clinical signs disappeared, laboratory parameters normalized and follow-up 18F-FDG PET/CT demonstrated lack of glucose uptake in the vessels' walls. We observed remission. 18F-FDG PET/CT offers a possibility for early detection of inflammation in the vessels and could be used for assessment of therapy response. Performing this nuclear imaging method in a clinical setting, where there is suspicion of large-vessel vasculitis is of great benefit for the final outcome.
我们报告一例68岁女性，有4个月发热、乏力和体重减轻病史。她被归类为不明原因发热病例。体格检查正常，实验室检查显示贫血、C反应蛋白、红细胞沉降率和纤维蛋白原升高。诊断不明确，遂行18F-FDG PET/CT检查。图像显示升主动脉和降主动脉壁、锁骨下动脉壁、腹主动脉及双侧髂动脉近端有高葡萄糖摄取。巨细胞动脉炎的诊断可能性最大，遂开始使用类固醇治疗。治疗后，临床症状消失，实验室指标恢复正常，随访18F-FDG PET/CT显示血管壁无葡萄糖摄取。我们观察到病情缓解。18F-FDG PET/CT为早期检测血管炎症提供了可能，可用于评估治疗反应。在怀疑有大血管血管炎的临床环境中进行这种核成像方法对最终结果非常有益。
