Giant cell aortitis combined with arteritis and coarctation of the aorta in 3.5-month child: A case report and literature review

Abstract

A present case showing giant cell aortitis (GGA) with coarctation of the aorta can be considered unique, even after reviewing the literature. The case of a 3.5-month-old girl who suffered an acute viral infection with an increase in body temperature (up to 39.5°C), difficulty breathing, and diarrhea is described. The girl was diagnosed with nasopharyngitis, enterocolitis, meningoencephalitis; she died 20 hours after being hospitalized from multiple organ failure. Clinical and laboratory data were collected, and a pathological examination was performed. Histological examination of the aorta and its main branches, such as the brachiocephalic trunk, left common carotid artery, left subclavian artery, as well as internal organs, was performed using hematoxylin-eosin, Hart's resorcin-fuchsin, Weigert's picrofuchsin, and Masson's trichrome. Pathological examination revealed giant cell aortitis and arteritis with coarctation of the aorta. GCA, in our case, had pathomorphological signs. First, many plaques that protruded into the lumen of the aorta and main branches, such as the brachiocephalic trunk, left common carotid artery and left subclavian artery, had a conical end that resembled the appearance of a rash. Second, granulomatous inflammation was localized in the intima of the aorta and all layers of the above-mentioned arteries.

Our case of GCA in a 3.5-month-old girl is the youngest patient among those described. We first describe GCA in relation to other severe aortic diseases. Coarctation, in combination with an aneurysm of the ascending aorta and aortitis, is a pathology that has not yet been described.