Transient Aortitis/Periaortitis with Spontaneous Resolution: Report of Four Cases

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ID: 326258
2026
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Abstract
Abstract Periaortitis is an inflammatory condition surrounding the aorta, classified as either idiopathic or secondary to well-defined causes; it typically requires treatment with glucocorticoids (GC) and/or immunosuppressants (IS). We report four cases of transient aortitis/periaortitis and summarize their characteristics and clinical courses. The four patients were all women (age range, 37–80 years). All patients had fever; three had dry cough and two experienced back or neck pain near the affected aortic site. At diagnosis, computed tomography (CT) revealed eccentric low-density areas in the periaortic space in all cases, involving the aortic arch or descending thoracic aorta in three patients. No carotid artery involvement was observed. One patient received low-dose GC for erythema nodosum, whereas the others did not receive GC or IS. The C-reactive protein (CRP) level was elevated in all cases. Symptoms and the CRP levels typically improved within approximately one month, and follow-up CT performed within approximately three months showed resolution in all cases. These four cases suggest the presence of a transient form of aortitis/periaortitis that improves without high-dose GC or IS. Notably, the thoracic aorta was predominantly affected, an unusual finding in chronic periaortitis. These cases may overlap with a spontaneous form of isolated aortitis and share informative features with transient perivascular inflammation of the carotid artery (TIPIC) syndrome and granulocyte colony-stimulating factor (G-CSF)-induced aortitis. Awareness of this condition may reduce unnecessary diagnostic workup and overtreatment; thus, additional case accumulation and further research are warranted to clarify its clinical spectrum and pathogenesis.
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Authors Y. Motomura, Nobuhiro Oda, Hiroki Ikai, Hiroshi Shiba, Ryo Hazue, Asami Kiuchi, Naoki Oya, Naoho Takizawa, Masahiro Minoda, Ryo Rokutanda
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Journal Modern Rheumatology Case Reports
Year 2026
DOI
10.1093/mrcr/rxag079
URL
https://doi.org/10.1093/mrcr/rxag079
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