Spontaneous Regression Of An Abdominal Aortic Aneurysm In An Immunocompromised Patient
Bellows, P. H., Anaya-Ayala, J. E., Younes, H. K., Charlton-Ouw, K. M., Bismuth, J., Davies, M. G., & Peden, E. K. (2010). spontaneous regression of an abdominal aortic aneurysm in an immunocompromised patient. Vascular medicine (London, England), 15(4), 315–319. https://doi.org/10.1177/1358863X10375331
View Original Source →Abstract
Spontaneous aneurysmal regression is a rare event, having been observed only in association with arteritides or immunosuppression following solid-organ transplantation. In particular, the spontaneous regression of an aortic aneurysm, to our knowledge, has never been documented. We report a case of a 46-year-old, HIV-positive, African-American man who developed an asymptomatic juxtarenal abdominal aortic aneurysm, which significantly regressed over a 6-month period in the absence of arteritides or systemic immunosuppressive therapy. This case describes the spontaneous regression of an inflammatory AAA in an HIV-positive patient. Further studies will be required to determine if this was an isolated occurrence or if it occurs with any frequency in specific patient populations.
Case Details
Disease Location
Abdomen
Personal Characteristics
46-year-old african-american male HIV-positive with a history of hypertension, peripheral artery disease, gastroesophageal reflux and peptic ulcerative disease. He was on an antiretroviral regimen of nucleoside analog reverse tran- scriptase inhibitors, tenofovir (gilead) and lamivudine (glaxosmithkline), and a non-nucleoside reverse tran- scriptase inhibitor, efavirenz (bristol-myers squibb).
Clinical Characteristics
Abdominal pain. Abdominal CT revealed a juxtarenal abdominal aortic aneurysm. Maximal diameter of 5.5 cm.
Remission Characteristics
Three months later diagnosis, the ap diameter of the aneurysm at the level of the bifurcation regressed to 3.3 cm and the juxtarenal aneurysm's diameter increased to 3.7 from 2.7 cm
Treatment & Mechanisms
Proposed Remission Mechanisms
Suspected inflammatory component of the aneurysm. If the case, regression could have been secondary to progressive immunosuppression. Another explanation for the decreased inflammation may be the patient's haart regimen.
Clinical Treatment
Tenofovir, lamivudine, efavirenz