Ascending aorta aneurysm in scleroderma

Ascending aorta aneurysm in scleroderma can be ascribed to its macrovascular involvement which is very less elucidated. We here describe a 56-year-old female with rapidly progressive diffuse cutaneous scleroderma. She presented with skin thickening involving all four limbs, thorax and abdomen. She had other features like arthritis, Raynaud’s phenomena, dyspnoea, heaviness of chest, and dysphagia. On investigation, she was strongly positive for antinuclear antibody and Scl 70. Imaging revealed interstitial lung disease (nonspecific interstitial pneumonia pattern) and a fusiform dilatation of ascending aorta of 6.5 cm. Patient was offered surgical correction for aneurysm, for which she refused. To the best of our knowledge, our case report adds up to the few cases of ascending aorta aneurysm in scleroderma available in world literature.

1. Abraham, DJ, Varga, J. Scleroderma: from cell and molecular mechanisms to disease models. Trends Immunol 2005; 26(11): 587–595.
Google Scholar | Crossref | Medline2. Kahaleh, MB . Raynaud phenomenon and the vascular disease in scleroderma. Curr Opin Rheumatol 2004; 16(6): 718–722.
Google Scholar | Crossref | Medline3. Ho, M, Veale, D, Eastmond, C, et al. Macrovascular disease and systemic sclerosis. Ann Rheum Dis 2000; 59(1): 39–43.
Google Scholar | Crossref | Medline4. Cheng, KS, Tiwari, A, Boutin, A, et al. Carotid and femoral arterial wall mechanics in scleroderma. Rheumatology 2003; 42(11): 1299–1305.
Google Scholar | Crossref | Medline5. Andersen, GN, Nilson, LM, Kazzam, E, et al. Assessment of vascular function in systemic sclerosis. Arthritis Rheum 2002; 46: 1324–1332.
Google Scholar | Crossref | Medline6. Kaku, Y, Kouda, K, Yoshimura, S, et al. Cerebral aneurysms in scleroderma. Cerebrovasc Dis 2004; 17: 339–341.
Google Scholar | Crossref | Medline7. Moyssakis, I, Gialafos, E, Vassiliou, V, et al. Aortic stiffness in systemic sclerosis is increased independently of the extent of skin involvement. Rheumatology 2005; 44: 251–254.
Google Scholar | Crossref | Medline8. Rodnan, GP, Myerowitz, RL, Justh, GO. Morphologic changes in the digital arteries of patients with progressive systemic sclerosis (scleroderma) and Raynaud phenomenon. Medicine 1980; 59(6): 393–408.
Google Scholar | Crossref | Medline9. Lederle, FA . Ultrasonographic screening for abdominal aortic aneurysms. Ann Intern Med 2003; 139: 516–522.
Google Scholar | Crossref | Medline10. Koch, AE, Haines, GK, Rizzo, RJ, et al. Human abdominal aortic aneurysms. Immunophenotypic analysis suggesting an immune-mediated response. Am J Pathol 1990; 137: 1199–1213.
Google Scholar | Medline11. Klima, T, Spjut, HJ, Coelho, A, et al. The morphology of ascending aortic aneurysms. Hum Pathol 1983; 14(9): 810–817.
Google Scholar | Crossref | Medline12. Seo, YH, Lee, SI, Yoo, WH. Thoracoabdominal aortic aneurysm associated with systemic sclerosis. Rheumatology 2005; 44: 1459–1461.
Google Scholar | Crossref | Medline13. Attaran, RR, Guarraia, D. Ascending aortic aneurysm in a man with scleroderma. Clin Rheumatol 2007; 26(6): 1027–1028.
Google Scholar | Crossref | Medline14. Nardi, P, Ruvolo, G. Current indications to surgical repair of the aneurysms of ascending aorta. J Vasc Endo Surg 2016; 1: 2.
Google Scholar

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