Aortitis-Diagnostics, differential diagnoses and treatment

Aortitis can have infectious or inflammatory rheumatic causes. Infectious aortitis must be treated with antibiotics or antimycotics and is not the primary subject of this review article. The main rheumatic forms include giant cell arteritis (GCA) and Takayasu arteritis (TAK). The GCA affects patients over 50 years of age, while TAK typically occurs in younger patients. Women are affected more often than men. In GCA, in addition to the involvement of the aorta, inflammation of the cranial branches of the aorta can also occur with the dreaded complication of blindness due to ischemia of the eye. The diagnostics are primarily carried out by imaging using positron emission tomography-computed tomography (PET-CT) or magnetic resonance imaging (MRI). If surgery on the vessel is necessary, a histological investigation should be carried out. If left untreated, it is a highly inflammatory disease with a limited prognosis. Immunosuppressive therapy usually achieves complete control of the inflammation. In addition to glucocorticoids, the interleukin 6 (IL-6) receptor inhibitor tocilizumab and methotrexate (MTX) are used.