Carotidynia Possibly due to Localized Vasculitis in a Patient with Latent Mycobacterium tuberculosis Infection. (2nd December 2013)

• Record Type: Journal Article
• Authors: Cassone, Giulia; Colaci, Michele; Giuggioli, Dilia; Manfredi, Andreina; Sebastiani, Marco; Ferri, Clodoveo
• Other Names: Etgen T. Academic Editor.; Naess H. Academic Editor.; Reinhard M. Academic Editor.
• Is Part Of: Case reports in vascular medicine. Volume 2013(2013)
• Publication Date: 2013-12-02
• Subjects: Peripheral vascular diseases -- Periodicals; 616.13005
• DOI: 10.1155/2013/585789
• Languages: English
• ISSNs: 2090-6986

Abstract

Abstract : Carotidynia is a syndrome characterized by tenderness of the carotid artery near the bifurcation due to numerous, heterogeneous causes. Here we reported the case of a 31-year-old Moroccan woman with right-sided neck pain and tenderness with irradiation to ipsilateral ear, eye, and occipital region. Clinical symptoms and imaging findings were suggestive of primary variant of carotidynia syndrome. In particular, color-Doppler ultrasonography revealed a concentric wall thickening of the distal common carotid artery, while thoracic magnetic resonance showed localized perivascular enhancement of the soft tissue in the right medial-distal common carotid artery in T1-weighted images, without intraluminal diameter variation. Moreover, careful clinicoserological and imaging investigations (cranial, cervical, and thoracic angiocomputed tomography and magnetic resonance) excluded well-known disorders potentially responsible for carotidynia syndrome. The patient was scarcely responsive to nonsteroidal anti-inflammatory drugs, but clinical symptoms resolved after three months. Of interest, the patient showed latent Mycobacterium tuberculosis infection (positive tuberculosis interferon-gamma release assay; QuantiFERON-TB Gold); this finding suggested a possible triggering role of mycobacterial antigens in the immune-mediated mechanism responsible for localized carotid injury.