2017 Volume 29 Issue 2 Pages 107-113
Inflammatory abdominal aortic aneurysm (IAAA) accounts for 2-14 % of all cases of abdominal aortic aneurysm (AAA). IAAA is a subtype of AAA pathologically characterized by aortic wall thickening, fibrotic change around aneurysm and rigid adherence of the adjacent structures. Recently, IAAA has been a subset of chronic periaortitis, along with idiopathic retroperitoneal fibrosis because of the similarity of histological features between these disease entities. We report here a 50-year-old woman who was diagnosed with IAAA during therapy for rheumatoid arthritis. She was treated with prednisolone 4mg/day, methotrexate (MTX) 8mg/week and golimumab 50mg/month for rheumatoid arthritis. She was also treated with levothyroxine for hypothyroidism induced by radioiodine therapy for Graves’ disease. In 2015, she presented with low grade fever and lower abdominal pain. Computed tomography revealed an abdominal aortic aneurysm and [18F]fluorodeoxyglucose positron emission tomography /computed tomography (FDG-PET/CT) showed the uptake of FDG in thickening wall of aorta. She was diagnosed as having IAAA and the prednisolone was increased to a dose of 30 mg daily, which proved to be effective.
