Kroonarterite

Kroonarterite is a rare, poorly defined inflammatory condition described in a small number of case reports and non-English sources as inflammation of the crown arteries, a term used for vessels around the aortic root and proximal coronary arteries. It is not widely recognized in English-language guidelines or major vascular classifications.

Clinical features are nonspecific and may include chest pain, fever, malaise, and elevated inflammatory markers. When coronary involvement occurs, angina or myocardial ischemia may ensue, potentially leading to myocardial infarction in severe cases.

Etiology is presumed to be immune-mediated, possibly related to other vasculitides, but the exact mechanism remains unknown. The condition has mainly been reported in isolated cases or small series, with variable histopathology similar to other large- and medium-vessel vasculitides.

Diagnosis relies on clinical suspicion and exclusion of other causes, supported by imaging and laboratory testing. Imaging options include CT or MR angiography of the aortic root and proximal coronaries, and PET-CT to detect vascular inflammation. Laboratory markers such as C-reactive protein and erythrocyte sedimentation rate may be elevated. Tissue biopsy is rarely obtained but may be used in select cases.

Treatment follows general vasculitis principles. Corticosteroids are typically first-line, with immunosuppressants (for steroid-sparing or refractory disease) and, in some cases, biologic therapies targeting inflammatory pathways. Management also includes treatment of cardiovascular risk factors and protection of myocardial health.

Epidemiology and prognosis: Kroonarterite is exceedingly rare, with no standardized criteria or guidelines. Outcomes vary with the extent of vascular involvement and response to therapy, and long-term prognosis remains uncertain due to scarce data.

Notes: The term is not widely used in English-language medical literature; readers should consult broader vasculitis resources for related conditions.