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Partially thrombosed aneurysm of the abdominal aorta: Unusual cause of chronic inflammation and resistance to recombinant human erythropoietin.

El Amrani M, El Kharras A, Asserraji M - Indian J Nephrol (2014)

Bottom Line: Diagnosis of chronic inflammatory syndrome is often a challenge.Investigations showed a partially thromosed aneurysm of the infrarenal aorta.Antiplatelet therapy was started with a satisfactory outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysis, First Medical and Surgical Center, Agadir, Morocco.

ABSTRACT
Diagnosis of chronic inflammatory syndrome is often a challenge. In dialysis patients, this condition leads to resistance to recombinant human erythropoietin (rHuEPO). We here report a case of a 72-year-old male undergoing chronic hemodialysis and developed rHuEPO resistance without any obvious etiology. Investigations showed a partially thromosed aneurysm of the infrarenal aorta. Antiplatelet therapy was started with a satisfactory outcome.

No MeSH data available.


Related in: MedlinePlus

Lateral abdominal X-ray: Aneurysm of the abdominal aorta
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Figure 2: Lateral abdominal X-ray: Aneurysm of the abdominal aorta

Mentions: Transthoracic echocardiogram, blood culture, abdominal and pelvic ultrasound, eso-gastric endoscopy, and colonoscopy showed no abnormalities. As part of a screening study of vascular calcifications in hemodialysis, our patient underwent a lateral abdominal X-ray, which demonstrated diffuse calcifications of the abdominal aorta and a large aneurysm extending from the second to the fourth lumbar vertebra [Figure 2]. Multislice spiral computed tomography-angiography with 3D-reconstruction showed a saccular dilatation of the infrarenal segment of the abdominal aorta measuring 70 mm in height, 41 mm of anteroposterior diameter and 40 mm in transverse diameter with diffuse calcification of both anterior and posterior wall of the aorta extending to the primitive iliac arteries [Figure 3]. There was no evidence of dissection or rupture. Cross sections showed a partial thrombosis of the aorta wall [Figure 4]. The diagnosis of CIS complicating a partially thrombosed aneurysm of the abdominal aorta was then made. Antiplatelet therapy by lysine acetylsalicylate 160 mg/day was introduced to prevent embolic complications. Follow-up over last 6 months showed regression of inflammation, improvement of Hb level, and reduction of rHuEPO doses [Figure 1].


Partially thrombosed aneurysm of the abdominal aorta: Unusual cause of chronic inflammation and resistance to recombinant human erythropoietin.

El Amrani M, El Kharras A, Asserraji M - Indian J Nephrol (2014)

Lateral abdominal X-ray: Aneurysm of the abdominal aorta
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927190&req=5

Figure 2: Lateral abdominal X-ray: Aneurysm of the abdominal aorta
Mentions: Transthoracic echocardiogram, blood culture, abdominal and pelvic ultrasound, eso-gastric endoscopy, and colonoscopy showed no abnormalities. As part of a screening study of vascular calcifications in hemodialysis, our patient underwent a lateral abdominal X-ray, which demonstrated diffuse calcifications of the abdominal aorta and a large aneurysm extending from the second to the fourth lumbar vertebra [Figure 2]. Multislice spiral computed tomography-angiography with 3D-reconstruction showed a saccular dilatation of the infrarenal segment of the abdominal aorta measuring 70 mm in height, 41 mm of anteroposterior diameter and 40 mm in transverse diameter with diffuse calcification of both anterior and posterior wall of the aorta extending to the primitive iliac arteries [Figure 3]. There was no evidence of dissection or rupture. Cross sections showed a partial thrombosis of the aorta wall [Figure 4]. The diagnosis of CIS complicating a partially thrombosed aneurysm of the abdominal aorta was then made. Antiplatelet therapy by lysine acetylsalicylate 160 mg/day was introduced to prevent embolic complications. Follow-up over last 6 months showed regression of inflammation, improvement of Hb level, and reduction of rHuEPO doses [Figure 1].

Bottom Line: Diagnosis of chronic inflammatory syndrome is often a challenge.Investigations showed a partially thromosed aneurysm of the infrarenal aorta.Antiplatelet therapy was started with a satisfactory outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysis, First Medical and Surgical Center, Agadir, Morocco.

ABSTRACT
Diagnosis of chronic inflammatory syndrome is often a challenge. In dialysis patients, this condition leads to resistance to recombinant human erythropoietin (rHuEPO). We here report a case of a 72-year-old male undergoing chronic hemodialysis and developed rHuEPO resistance without any obvious etiology. Investigations showed a partially thromosed aneurysm of the infrarenal aorta. Antiplatelet therapy was started with a satisfactory outcome.

No MeSH data available.


Related in: MedlinePlus