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Vol. 12. Issue 2.
Pages 103-106 (March - April 2016)
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Vol. 12. Issue 2.
Pages 103-106 (March - April 2016)
Case report
DOI: 10.1016/j.reumae.2015.03.018
A Classic Mimicker of Systemic Vasculitis
Un simulador clásico de vasculitis sistémica
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Marc Moreno-Ariñoa,
Corresponding author
mmorenoa@fhag.es

Corresponding author.
, Vera Ortiz-Santamariab,c, Aída Deudero Infanted, Montserrat Ayats Delgadoe, Francesc Novell Teixidóf
a Servicio de Geriatría, Hospital General de Granollers, Granollers, Barcelona, Spain
b Unidad de Reumatología, Servicio de Medicina Interna, Hospital General de Granollers, Granollers, Barcelona, Spain
c Departamento de Medicina, Universidad Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
d Servicio de Medicina Interna, Hospital General de Granollers, Granollers, Barcelona, Spain
e Unidad de Cardiología, Servicio de Medicina Interna, Hospital General de Granollers, Granollers, Spain
f Servicio de Diagnóstico por la Imagen, Hospital General de Granollers, Granollers, Spain
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Table 1. Clinical Manifestations in the Cases of Cardiac Tumors Mimicking Vasculitides or Connective Tissue Diseases Reported in the Medical Literature.
Abstract
Background and objective

Embolic and constitutional manifestations of intracavitary cardiac tumors are included within the classic mimickers of systemic vasculitis, especially in those in which there are no cardiac manifestations. We present a case report of atrial myxoma in which the patient only presented systemic symptoms and in whom an initial diagnostic approach of systemic vasculitis was made. We also performed a literature search of the cases described.

Patient and method

A case report of atrial myxoma with atypical presentation manifested as a systemic disease with no concomitant cardiac symptoms is described. The case report is discussed and 11 cases of atrial myxoma pseudovasculitis described in the literature are reviewed, emphasizing their similarities and differences.

Discussion

Constitutional symptoms and cutaneous manifestations were the most common. Most of the cases showed partial response to glucococorticosteroid treatment, reinforcing the theory of the inflammatory role in its pathogenesis. Mean delayed time to diagnosis was 12.27 months.

Conclusion

Atrial myxoma is a systemic vasculitis mimicker, this being difficult to diagnose in the absence of cardiac manifestations. This delay in diagnosis entails serious complications.

Keywords:
Myxoma
Cardiac tumor
Systemic vasculitis
Pseudovasculitis
Mimicker
Resumen
Fundamento y objetivo

Las manifestaciones embolígenas y constitucionales de los tumores cardíacos intracavitarios se engloban dentro de los mimetizadores clásicos de las vasculitis sistémicas, sobre todo en aquellas ocasiones donde no se presentan manifestaciones cardiológicas. Se describe un caso de mixoma auricular con clínica exclusivamente sistémica, cuya orientación diagnóstica inicial fue de vasculitis. Se revisan los casos descritos en la literatura.

Paciente y método

Se describe un caso de mixoma auricular con presentación en forma de manifestaciones sistémicas sin sintomatología cardiológica acompañante. Se expone el caso clínico y se compara con 11 casos de seudovasculitis por mixoma auricular descritos en la literatura, haciendo énfasis en las similitudes y divergencias.

Discusión

Los síntomas constitucionales junto con las manifestaciones cutáneas fueron los más frecuentes. La mayoría de los casos presentaban respuesta parcial al tratamiento glucocorticoideo, reforzando la teoría del componente inflamatorio en su patogenia. La demora media en el diagnóstico fue de 12,27 meses.

Conclusión

El mixoma auricular es un simulador de vasculitis sistémica y es de difícil diagnóstico cuando no presenta manifestaciones cardíacas. La demora diagnóstica puede conllevar complicaciones graves.

Palabras clave:
Mixoma
Tumor cardíaco
Vasculitis sistémica
Seudovasculitis
Simulador

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