Nephrology Center and Department of Rheumatology, Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Department of Urology, Toranomon Hospital, Japan.
Intern Med. 2023;62(11):1625-1629. doi: 10.2169/internalmedicine.0305-22. Epub 2023 Jun 1.
A 74-year-old woman was admitted because of malaise and a low-grade fever. Her C-reactive protein level was 0.96 mg/dL. Computed tomography (CT) revealed diffuse uniform thickening of the arterial wall from the abdominal aorta to the common iliac artery and right hydronephrosis. F-fluordesoxyglucose positron emission tomography-CT showed an accumulation in the same area. These findings suggested Takayasu arteritis and retroperitoneal fibrosis as differential diagnoses. Takayasu arteritis is characterized by thickening of the arterial walls, and retroperitoneal fibrosis is characterized by membranous lesions covering the outer surface of the arterial walls. Thus, Takayasu arteritis was deemed the most likely diagnosis. Steroid treatment was effective.
一位 74 岁女性因不适和低热入院。她的 C-反应蛋白水平为 0.96mg/dL。计算机断层扫描（CT）显示从腹主动脉到髂总动脉和右侧肾积水的动脉壁弥漫性均匀增厚。氟代脱氧葡萄糖正电子发射断层扫描-CT 显示在同一区域有积聚。这些发现提示 Takayasu 动脉炎和腹膜后纤维化作为鉴别诊断。Takayasu 动脉炎的特征是动脉壁增厚，腹膜后纤维化的特征是覆盖在动脉壁外表面的膜性病变。因此，Takayasu 动脉炎被认为是最可能的诊断。类固醇治疗有效。
