Differential Diagnosis
- Single most likely diagnosis
- Polyarteritis nodosa (PAN): This condition is characterized by inflammation of medium-sized arteries, which can lead to a wide range of symptoms including oral ulcers, skin rash, abdominal pain, and renal involvement. The CT findings of inflammation in the renal, iliac, and descending aorta are consistent with PAN.
- Other Likely diagnoses
- Syphilis: Syphilis can cause a wide range of symptoms including skin rashes, oral ulcers, and abdominal pain. It can also cause aortitis, which could explain the CT findings. However, syphilis typically affects the ascending aorta, whereas the CT findings in this case show involvement of the renal, iliac, and descending aorta.
- Do Not Miss
- Giant Cell Arteritis (GCA): Although GCA typically affects the branches of the external carotid artery and the aorta, it can cause aortitis and lead to symptoms similar to those described. GCA is a medical emergency, and missing the diagnosis could lead to serious complications, including blindness and aortic aneurysm.
- Takayasu Arteritis: This is a large vessel vasculitis that can cause inflammation of the aorta and its branches, leading to symptoms similar to those described. Takayasu arteritis can be life-threatening if left untreated, and it is essential to consider it in the differential diagnosis.
- Rare diagnoses
- Atherosclerosis: Although atherosclerosis can cause inflammation of the aorta, it typically affects older adults and is associated with risk factors such as hypertension, hyperlipidemia, and smoking. The presence of oral ulcers and skin rash makes atherosclerosis a less likely diagnosis.
- Kawasaki Disease: This is a rare condition that typically affects children and causes inflammation of medium-sized arteries. Although it can cause symptoms similar to those described, it is unlikely in an adult patient.
- Behçet's Disease: This is a rare condition that causes inflammation of blood vessels throughout the body, leading to symptoms such as oral ulcers, skin rash, and abdominal pain. Although it is a possible diagnosis, it is less likely than PAN or other vasculitides.