Asymptomatic acute aortic dissection in a CKD5 patient, suspected with high CRP and minimal pleural effusion

Iwasaki Masaki, Joki Nobuhiko, Otsuka Takenori, Ishikawa Hiroyasu, Inishi Youji, Tanaka Yuri, Sugi Kaoru, Hase Hiroki

doi:10.4009/jsdt.42.785

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Other Title

高ＣＲＰ血症が重要な診断手掛かりとなったＣＫＤ患者に合併した無症候性急性大動脈解離の１例
症例報告高CRP血症が重要な診断手掛かりとなったCKD患者に合併した無症候性急性大動脈解離の1例
ショウレイホウコクコウCRP ケツショウガジュウヨウナシンダンテガカリトナッタ CKD カンジャニガッペイシタムショウコウセイキュウセイダイドウミャクカイリノ 1レイ

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Description

Sudden onset of back pain is well known as a typical symptom of acute aortic dissection. In the clinical setting, it is not difficult to make a precise diagnosis of acute aortic dissection based on imaging findings along with this typical symptom. A 70-year-old man with chronic kidney disease stage 5 consulted our hospital for a scheduled appointment. He had no symptoms and no clinical signs on physical examination ; however, his serum C-reactive protein (CRP) was extremely high (19.0 mg/dL). Even on further examination, there were no significant abnormal findings except for a small collection of left pleural effusion on chest X-ray. Since the pleural effusion was independent of the decrease in body weight by dialysis, we performed chest computed tomography to investigate the cause of pleural effusion. Surprisingly, chest CT scan clearly showed dissection of the thoracic aorta, resulting in a diagnosis of Stanford type B aortic dissection. High serum CRP was the only sign indicating onset of aortic dissection in this case.

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 42 (10), 785-790, 2009

The Japanese Society for Dialysis Therapy

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