AORTITIS SPECTRUM. STUDY OF 82 PATIENTS FROM A SINGLE REFERRAL CENTER

L. Sanchez-Bilbao, J. Loricera, C. Secada-Gómez, A. Martínez Gutiérrez, L. García-Alcalde, M. Nuñez-Sayar, A. Ucelay-Aristi, C. Álvarez-Reguera, A. Herrero-Morant, R. BlancoHospital Universitario Marqués de Valdecilla, IDIVAL, Rheumatology, Santander, Spain Hospital Universitario Marqués de Valdecilla, Cadiovascular Surgery, Santander, Spain  Background Aortitis is the inflammation of the aortic wall, and can be idiopathic or associated with a cluster of infectious and non-infectious diseases. Giant-cell arteritis (GCA) and Takayasu arteritis (TA) are the most common underlying [1,2]. Objectives To assess the causes and the main features of patients with aortitis. Methods Observational study of patients with aortitis from a large-vessel vasculitis monographic consultation at a referral hospital from June 2022 to December 2022. Aortitis was diagnosed by imaging techniques. Results We present 82 patients (52 female/ 30 male) (mean±SD age; 60.2±12.6 years). The different subtypes of aortitis were: GCA (n=69), Takayasu arteritis (n=6), other inflammatory autoimmune diseases (n=3), IgG4-related disease (IgG4-RD) (n=2), syphilis (n=1) and isolated aortitis (n=1). The imaging techniques used for the diagnosis of aortitis were: PET/TAC (n=81), TAC (n=23), RMN (n=20) and arteriography (n=10). The main features of the patients are summarized in Table 1. Aortitis was most frequent in women. 50% patients had high blood pressure and dyslipidaemia. Polymyalgia rheumatica and asthenia were more frequent manifestations. The underlying diseases in the group of aortitis related to other inflammatory autoimmune diseases were: ulcerative colitis (n=1), idiopathic retroperitoneal fibrosis (n=1), and polyarteritis nodosa (n=1). The ascending thoracic aorta and the supraaortic trunks were the most frequently involved segments (Figure 1). Conclusion Aortitis is an entity which can be isolated or secondary to infectious and non-infectious process. Among the non-infectious causes, GCA and TA are the most frequent, being common the presence of PmR and asthenia. The ascending thoracic aorta and the supraaortic trunks seems to be the most frequently involved segments. References Loricera J, et al. Clin Exp Rheumatol. 2015. PMID: 25437450 Loricera J, et al. Clin Exp Rheumatol. 2014. PMID: 24854377 Image/graph:Figure 1. Segments of the aorta affected. All data are in %. Table 1. Main features of the patients with aortitis. FEATURES OVERALL (n=82) GCA PATIENTS (n=69) TA PATIENT(n=6) RELATED TO OTHER INFLAMMATORY DISEASES (n=3) IgG4-RD (n=2) Age (years), mean±SD 60.2±12.6 66.1±10.0 41.8±14.1 52±18.7 51.5±7.8 Female/Male (% female) 52/30 (63) 43/26 (62) 6/0 (100) 2/1 (67) 1/1 (50) High blood pressure, n (%) 41 (50) 34 (49) 4 (67) 2 (67) 1 (50) Dyslipidaemia, n (%) 41 (50) 33 (48) 4 (67) 2 (67) 0 (0) Diabetes mellitus, n (%) 12 (15) 12 (17) 0 (0) 0 (0) 0 (0) Active smoker or ex-smoker, n (%) 27 (33) 20 (29) 5 (83) 0 (0) 0 (0) Asthenia, n (%) 39 (48) 33 (48) 4 (67) 0 (0) 2 (100) Weight loss, n (%) 22 (27) 19 (27) 2 (33) 0 (0) 1 (50) PmR, n (%) 40 (49) 39 (56) 0 (0) 0 (0) 1 (50) Fever, n (%) 11 (13) 9 (13) 1 (17) 1 (33) 0 (0) Headache, n (%) 32 (39) 29 (42) 2 (33) 0 (0) 1 (50) Visual symptoms, n (%) 14 (17) 12 (17) 1 (17) 0 (0) 1 (50) Jaw claudication, n (%) 10 (12) 10 (14) 0(0) 0 (0) 0 (0) Lumbar pain, n (%) 25 (30) 22 (32) 2 (33) 0 (0) 1 (50) Pain in thighs, n (%) 18 (22) 17 (25) 1 (17) 0 (0) 0 (0) Upper Limb claudication, n (%) 21 (26) 19 (27) 2 (33) 0 (0) 0 (0) Lower limb claudication 17 (21) 14 (20) 2 (33) 1 (33) 0 (0) CRP (mg/dL), median [IQR] 0.4 [0.4-1.6] 0.5 [0.4-1.7] 0.4 [0.2-2.0] 0.4 [0.3-0.4] 1.5 [0.9-2.0] ESR (mm/1h), median [IQR] 13 [5-45.2] 14 [5-48] 16.5 [3.5-32.5] 12 [7-24] 7.5 [6.7-8.2 Abbreviations: CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, GCA: giant cell arteritis, IgG4-RD: IgG4-related disease, PmR: polymyalgia rheumatica, TA: Takayasu arteritis Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: Real-world evidence, Vasculitis DOI: 10.1136/annrheumdis-2023-eular.5317Citation: , volume 82, supplement 1, year 2023, page 1569Session: Vasculitis - large vessel vasculitis (Publication only)