VEXAS Syndrome With Tracheal Involvement but Absence of Vasculitis in FDG PET/CT

Clin Nucl Med. 2023 Sep 1;48(9):e444-e445. doi: 10.1097/RLU.0000000000004770. Epub 2023 Jul 5.

Abstract

In early 2022, a 77-year-old man presented with weight loss and recurrent subfebrile temperatures since 6 months. Workup with CT revealed a lung infiltrate. Despite antibiotic treatment, serum inflammation markers remained high. The patient further developed eczematous skin changes, uveitis (sequentially on both eyes), and macrocytic anemia. Finally, an autoinflammatory disease was suspected, and FDG PET/CT was performed. The examination revealed metabolically active foci in several tissues (tracheal cartilage, bone marrow, muscles). Bone marrow aspiration revealed an UBA1 mutation, which is pathognomonic for VEXAS syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Mutation
  • Positron Emission Tomography Computed Tomography*
  • Positron-Emission Tomography
  • Vasculitis* / diagnostic imaging

Substances

  • Fluorodeoxyglucose F18

Supplementary concepts

  • VEXAS syndrome