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Further blood tests revealed a high CD4\/CD8 T-cell ratio, which can be seen in autoimmune disease, sarcoidosis and haematological malignancies. Without evidence for other autoimmune processes, the patient was given a provisional diagnosis of descending thoracic aortitis secondary to sarcoidosis, prescribed a weaning regimen of prednisolone, and asked to seek further investigation and management in her home country. This is a case with several learning points; rare disease can cause common presentations\/reports, and sometimes empirical therapy is the only therapy.<\/jats:p>","DOI":"10.1136\/bcr-2020-238009","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T11:02:51Z","timestamp":1613646171000},"page":"e238009","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Clinically isolated descending thoracic aortitis in a healthy older woman: a diagnostic challenge"],"prefix":"10.1136","volume":"14","author":[{"given":"Max Amos","family":"Hoffman","sequence":"first","affiliation":[{"name":"Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2967-4645","authenticated-orcid":false,"given":"Adel","family":"Ekladious","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"2025082702301181000_14.2.e238009.1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s00772-016-0143-9","article-title":"Inflammatory diseases of the aorta: Part 1: non-infectious aortitis","volume":"21","author":"T\u00f6pel","year":"2016","journal-title":"Gefasschirurgie"},{"key":"2025082702301181000_14.2.e238009.2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00772-016-0142-x","article-title":"Inflammatory diseases of the aorta: Part 2: infectious aortitis","volume":"21","author":"T\u00f6pel","year":"2016","journal-title":"Gefasschirurgie"},{"key":"2025082702301181000_14.2.e238009.3","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7252"},{"key":"2025082702301181000_14.2.e238009.4","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.17-1-71"},{"key":"2025082702301181000_14.2.e238009.5","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s12016-013-8406-7","article-title":"Cogan's syndrome--clinical guidelines and novel therapeutic approaches","volume":"47","author":"Tayer-Shifman","year":"2014","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025082702301181000_14.2.e238009.6","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2018.02237","article-title":"Interpretation of serological complement biomarkers in disease","volume":"9","author":"Ekdahl","year":"2018","journal-title":"Front Immunol"},{"key":"2025082702301181000_14.2.e238009.7","doi-asserted-by":"crossref","unstructured":"JY H , R G , H F . 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