An Atypical Case of Vasculitis: When ‘Occult’ 18FDG-PET Scan Findings Create a Classification Dilemma
  • Elena Lopez-Francos
    Internal Medicine Department, Epicura Hospital, Baudour, Belgium
  • Sammy Place
    Internal Medicine Department, Epicura Hospital, Baudour, Belgium
  • Daphnee Delplace
    Dermatology Department, Epicura Hospital, Baudour, Belgium
  • Frédéric Vandergheynst
    Internal Medicine Department, CHU Erasme, Université Libre de Bruxelles, Brussels, Belgium

Keywords

Polyarteritis nodosa, polymyalgia rheumatica, giant cell arteritis (GCA), PET scan

Abstract

We describe a 66-year old patient with a recurrent ulcer on her right ankle. Biopsy revealed medium-vessel vasculitis consistent with cutaneous polyarteritis nodosa. There were no signs or symptoms suggestive of systemic vasculitis, but a 18FDG-PET scan showed areas of increased uptake around the large arteries and the pelvic and shoulder girdles. These findings suggested polymyalgia rheumatica in the setting of large-vessel vasculitis. This case thus supports the statement from the Chapel-Hill consensus conference that classification of systemic vasculitis by vessel size is based on the vessels predominantly involved, but vessels of other sizes may also be affected.

VIEW THE ENTIRE ARTICLE

References

  • Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012, Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65:1–11.

  • Kemna M, Vandergheynst F, Vöö S, Blocklet D, Nguyen T, Timmermans SA, et al. Positron emission tomography scanning in anti-neutrophil cytoplasmic antibodies-associated vasculitis. Medicine (Baltimore) 2015;94:e747.

  • Soussan M, Abisror N, Abad S, Nunes H, Terrier B, Pop G, et al. FDG-PET/CT in patients with ANCA-associated vasculitis: case-series and literature review. Autoimmunity Rev 2013;13:125-131.

  • Puigrenier S, Dognon N, Collet G, Duez JP, Quéméneur T. Utilisation du TEP-TDM dans la périartérite noueuse limitée aux membres inférieurs : à propos d’un cas. La Revue de Médecine Interne 2017;38(Suppl. 2):A119-A120 (abstract).

  • Schollhammer R, Schwartz P, Jullie ML, Pham-Ledard A, Mercie P, Fernandez P, et al. 18F-FDG PET/CT imaging of popliteal vasculitis associated with polyarteritis nodosa. Clin Nucl Med 2017;42:e385-e387.
  • Views: 1022
    HTML downloads: 152
    PDF downloads: 448


    Published: 2019-12-23
    Issue: 2020: Vol 7 No 1 (view)


    How to cite:
    1.
    Lopez-Francos E, Place S, Delplace D, Vandergheynst F. An Atypical Case of Vasculitis: When ‘Occult’ 18FDG-PET Scan Findings Create a Classification Dilemma. EJCRIM 2019;7 doi:10.12890/2019_001301.

    Most read articles by the same author(s)