Surreal illustration of aortitis and Sweet's syndrome connection

Rare Connections: When Aortitis Meets Sweet's Syndrome

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"Unveiling a Unique Case Study Linking Two Uncommon Conditions"

In the complex world of medicine, rare associations between different conditions can present unique challenges for diagnosis and treatment. A recent case study sheds light on one such association: the co-occurrence of aortitis and Sweet's syndrome.

Aortitis, an inflammation of the aorta, the body's largest artery, can lead to serious complications if left untreated. Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by painful skin lesions and fever. While both conditions are uncommon on their own, their simultaneous occurrence is exceedingly rare.

This article delves into a fascinating case report that explores the diagnosis, treatment, and implications of this unusual medical intersection. By examining the details of this case, we can gain a deeper understanding of the complexities of inflammatory conditions and the importance of considering rare associations in clinical practice.

The Case: A 67-Year-Old Woman's Unexpected Diagnosis

Surreal illustration of aortitis and Sweet's syndrome connection

The case study focuses on a 67-year-old woman with no significant past medical history who presented with sudden abdominal pain. Initially assessed in visceral surgery, an abdominal CT scan revealed aortitis, which was subsequently confirmed by an MRI. This prompted her transfer to the internal medicine service for further evaluation.

Upon examination, doctors noted a decline in her overall condition and diffuse abdominal tenderness. While she was afebrile and hemodynamically stable, a skin examination revealed painful, violet-red plaques on the palms of her hands. Blood tests indicated a biological inflammatory syndrome, with elevated markers such as a sedimentation rate of 125 mm in the first hour, CRP of 146 mg/L, and fibrinogen of 11.55 mg/L. She also presented with inflammatory anemia, with a hemoglobin level of 10.5 g/dL.

Diagnostic Investigations: Extensive testing was conducted to determine the cause of the aortitis. Blood cultures, syphilis serology, and tuberculosis screening were all negative. A temporal artery biopsy was also normal. However, a skin biopsy confirmed the diagnosis of Sweet's syndrome.
Diagnosis and Treatment: Based on the clinical and pathological findings, the patient was diagnosed with inflammatory aortitis, consistent with Horton's disease (giant cell arteritis), associated with Sweet's syndrome. Treatment was initiated with high-dose corticosteroids (1 mg/kg/day) and an antiplatelet agent.
Positive Outcomes: The patient's condition improved with treatment. Her overall condition, skin lesions, and biological abnormalities all resolved.

This case is significant because the association between Sweet's syndrome and aortitis has rarely been reported. While some cases have linked Sweet's syndrome with Takayasu's arteritis, its association with Horton's disease has not been previously documented, highlighting the uniqueness of this case.

Implications and Future Research

This case emphasizes the importance of considering rare associations in clinical practice. While Sweet's syndrome and aortitis are individually uncommon, their co-occurrence can present unique diagnostic and therapeutic challenges. Further research is needed to better understand the underlying mechanisms that link these conditions and to develop optimal treatment strategies. By recognizing these rare associations, clinicians can improve diagnostic accuracy and provide more effective care for patients with complex inflammatory disorders.

About this Article -

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Everything You Need To Know

What are the primary characteristics of Sweet's syndrome and aortitis?

Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by painful skin lesions and fever. Aortitis, on the other hand, is an inflammation of the aorta, the body's largest artery. The case study highlights the co-occurrence of these two uncommon conditions, emphasizing the complexity of their interaction and the diagnostic challenges they present.

How was the 67-year-old woman in the case study diagnosed with both aortitis and Sweet's syndrome?

The patient's diagnosis began with the presentation of sudden abdominal pain, leading to an abdominal CT scan that revealed aortitis. This was confirmed by MRI. Following the initial assessment, the patient was transferred to internal medicine for further evaluation. Subsequent examination revealed painful, violet-red plaques on the palms of her hands, prompting a skin biopsy which confirmed the diagnosis of Sweet's syndrome. Blood tests showed elevated inflammatory markers, supporting the diagnosis. Extensive testing, including blood cultures, syphilis serology, and tuberculosis screening, along with a temporal artery biopsy, helped to rule out other potential causes of the aortitis.

What were the key diagnostic investigations and findings that led to the final diagnosis in this case?

Several diagnostic investigations were crucial. Initially, the abdominal CT scan and MRI confirmed aortitis. Blood tests revealed a significant biological inflammatory syndrome, indicated by an elevated sedimentation rate, CRP levels, and fibrinogen levels, along with inflammatory anemia. A skin biopsy confirmed the diagnosis of Sweet's syndrome. Importantly, other tests such as blood cultures, syphilis serology, tuberculosis screening, and a temporal artery biopsy were conducted to rule out alternative causes. The final diagnosis was inflammatory aortitis, consistent with Horton's disease (giant cell arteritis), associated with Sweet's syndrome.

What was the treatment provided, and what were the outcomes for the patient?

The patient was treated with high-dose corticosteroids (1 mg/kg/day) and an antiplatelet agent. Following the treatment, the patient's condition improved significantly. The overall condition, skin lesions, and biological abnormalities all resolved, indicating a positive outcome from the therapeutic interventions. The resolution of these symptoms and markers highlighted the effectiveness of the treatment plan in managing the co-existing conditions.

Why is this case study considered significant, and what are the implications for future research and clinical practice?

This case is significant because the association between Sweet's syndrome and aortitis, particularly Horton's disease, has rarely been reported. While some cases have linked Sweet's syndrome with Takayasu's arteritis, its association with Horton's disease has not been previously documented. This highlights the uniqueness of the case, underscoring the importance of considering rare associations in clinical practice. Future research should focus on understanding the underlying mechanisms that link these conditions to improve diagnostic accuracy and provide more effective care for patients with complex inflammatory disorders. The case emphasizes that recognizing these rare associations can lead to better patient outcomes.