Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia

Araújo, Daniel Brito de; Oliveira, Danise Senna; Rovere, Rodrigo Kraft; Filho, Umberto Lopes de Oliveira

doi:10.5114/reum.2017.68916

Cited by 15 publications

(13 citation statements)

References 12 publications

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“…TAA has also been linked to inflammation and inflammatory diseases. Syphilis was once considered as one of the most common causes of ascending TAA 55 , and although extremely rare nowadays, recent cases of syphilis aortitis and TAA have been reported 62 . Aortic arteritis, which includes Takayasu’s arteritis and giant-cell arteritis, refers to a group of chronic inflammatory diseases of unknown etiologies, and is associated with a high prevalence of TAA 63,64 .…”

Section: Thoracic Aortic Aneurysm (Taa)mentioning

confidence: 99%

Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm

et al. 2019

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Aortic aneurysm is an asymptomatic disease with dire outcomes if undiagnosed. Aortic aneurysm rupture is a significant cause of death worldwide. To date, surgical repair or endovascular repair (EVAR) is the only effective treatment for aortic aneurysm, as no pharmacological treatment has been found effective. Aortic aneurysm, a focal dilation of the aorta, can be formed in the thoracic (TAA) or the abdominal (AAA) region; however, our understanding as to what determines the site of aneurysm formation remains quite limited. The extracellular matrix (ECM) is the noncellular component of the aortic wall, that in addition to providing structural support, regulates bioavailability of an array of growth factors and cytokines, thereby influencing cell function and behavior that ultimately determine physiological or pathological remodeling of the aortic wall. Here, we provide an overview of the ECM proteins that have been reported to be involved in aortic aneurysm formation in humans or animal models, and the experimental models for TAA and AAA and the link to ECM manipulations. We also provide a comparative analysis, where data available, between TAA and AAA, and how aberrant ECM proteolysis versus disrupted synthesis may determine the site of aneurysm formation.

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Section: Thoracic Aortic Aneurysm (Taa)mentioning

confidence: 99%

Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm

et al. 2019

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“…This results in the ischemic injury of the aortic media with variable loss of smooth muscle cells and associated parenchyma. Destruction of aortic media, focal necrosis surrounded by palisading macrophages (also known as microgummas) and calcification develop within fibrotic tissues, creates fusiform or saccular aneurysm due to loss of elastic recoil of the aorta [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the past decade, several cases of syphilitic thoracic aortic aneurysm have been reported with variable clinical presentation such as simultaneous involvement of the brain, spinal cord (neurosyphilis), lungs (pulmonary syphilis), and rupture or dissection of thoracic aortic aneurysm (cardiovascular syphilis) [ 5 , 7 , 16 - 20 ]. Our case is a classic presentation of isolated cardiovascular syphilis presented with a large thoracic aortic aneurysm confirmed with TP-PA testing and radiological imaging.…”

Section: Discussionmentioning

confidence: 99%

Syphilitic Aortic Aneurysm: A Rare Entity in the Era of Antibiotics

Chaudhary

Faghihimehr

Subedi

et al. 2021

Cureus

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A thoracic aortic aneurysm is a rare entity of tertiary syphilis in the era of antibiotics. The diagnosis of the aortic aneurysm due to tertiary syphilis may be challenging due to deceptive clinical presentation and rarity of the disease in the western world. We report the case of a 59-year-old man, who presents with worsening shortness of breath and was found to have a large ascending aortic aneurysm on computed tomography angiogram (CTA) of the chest. Further workup demonstrated a positive syphilis test. Untreated earlier stages of syphilis attribute to the development of the ascending aortic aneurysm. The patient was medically treated with IV penicillin and underwent surgical repair of the aortic aneurysm. Histopathology confirmed the diagnosis of syphilitic aortitis. Tertiary syphilis often presents several years after initial infection and usually after a latent phase, making it difficult to diagnose. Syphilitic aortic aneurysms may result in a high mortality rate in untreated patients. Therefore, a high index of suspicion is required for the early recognition of a syphilitic aortic aneurysm. Early treatment with antibiotic therapy and surgical repair of syphilitic aortic aneurysms can prevent life-threatening complications.

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“…It is a sexually transmitted disease and when it is found in the spine, it involves syphilitic gummas, stemmed from leptomeningeal inflammation and low signal intensity found on T2WIs [8][9][10][11][12]. Syphilis peaked during WWII, with a decline due to the founding of penicillin, yet it is still prevalent as a sexually transmitted disease [128,129].…”

Section: Syphilismentioning

confidence: 99%

“…For syphilis in the spinal region, patients are treated with benzathine penicillin [128,132]. In addition, it is critical that patients are treated rapidly, as complications can arise.…”

Section: Syphilismentioning

confidence: 99%

Parasitic Diseases Within the Spinal Cord and Nerve Roots

Rahmani

Patel

Seyam

et al. 2019

SN Compr. Clin. Med.

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Parasitic diseases of the spinal cord and nerve roots are a potentially deadly matter. They are mainly found in areas where there are poor sanitary conditions such as Africa, the Middle East, and the West Indies. The most common diseases include schistosomiasis and neurocysticercosis. Furthermore, it is clear that through an understanding of all the various diseases there are, it is imminent that patients are treated as soon as possible to avoid the deadly outcomes that the diseases can have to the body. This disease can have several impacts on individuals that include epilepsy, health problems, and implications on various organs.

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Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia

Cited by 15 publications

References 12 publications

Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm

Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm

Syphilitic Aortic Aneurysm: A Rare Entity in the Era of Antibiotics

Parasitic Diseases Within the Spinal Cord and Nerve Roots

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