SIR, Syphilis is a sexually-transmitted infectious disease caused by the bacteria Treponemapallidum. A characteristic manifestation of the third stage is arteritis of the aorta, which leads to necrosis and loss of tissue. Here, we report on a 48-year-old woman admitted with suspected Takayasu's arteritis (TA) due to localized inflammation confined to the aortic root and valve, which could be diagnosed as syphilitic aortitis. KeywordsVasculitis, Syphilis, Takayasu's Arteritis Letter to the EditorA 48-year-old patient was admitted to our tertiary Rheumatology center after composite aortic valve graft replacement had been performed the month before due to 70% stenosis of the aorta combined with an aortic valve insufficiency. The patient had developed 4 months prior to admission rapid signs of cardial decompensation. The pathohistological analysis of the resected tissue revealed aortitis with lympho-plasma cell rich infiltrations around vasa vasorum and lymphatic aggregates in the adventitia (Figure 1). In addition, there was a thickened vessel wall with slight fibredesorganisation and intramural lamelliform necrosis of the media with sparse neutrophilic granulocytes, lymphocytes and plasma cells (Figure 2). Immunohistochemical studies including stainings for CD68, IgG4 and CD138 did not provide additional information. Off note, there were no granulomas present. In light of these histopathological findings, infectious aortitis as well as localized idiopathic aortitis were considered by the pathologists, however, no information regarding an infection has been provided on request
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