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The authors address concern about syphilis by stating the case’s national registry records showed no sexually transmitted diseases and by reiterating established aortic dissection risk factors. They note that thoracic aortic involvement is common in syphilis but syphilitic aneurysms seldom dissect. Concluding that, in this case, Marfan syndrome contributed more to the dissection than syphilis, and disclosing research support and no conflicts of interest.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reply-to-comment-on-aortic-aneurysm-dissection-from-the-root-to-pelvis/417333/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reply-to-comment-on-aortic-aneurysm-dissection-from-the-root-to-pelvis/417333.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What concern does the editor’s correspondent raise about the authors’ case?","Question",{"text":112,"@type":113},"The correspondent raises concern about syphilis and its late consequences, including vasculitis and cardiovascular vascular complications.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do the authors address whether syphilis was present in the patient?",{"text":117,"@type":113},"They report that the patient’s national health registry record indicated no sexually transmitted diseases, and they reference risk factors listed in their Discussion section.",{"name":119,"@type":110,"acceptedAnswer":120},"What do the authors conclude about the dominant cause of the aortic dissection in this case?",{"text":121,"@type":113},"They conclude that the effect of Marfan syndrome outweighed the contribution of syphilis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},417333,1791037499,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","| Correspondence |\n| --- |\n|  |\n\nReply to Comment on Aortic Aneurysm: Dissection from the  \nRoot to Pelvis  \nLan‑Shin Jhang1, Chih‑Wei Chien2, An‑Shine Chao1,2*  \n1Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, 2Department of  \nObstetrics and Gynecology, Municipal New Taipei Tucheng Hospital, New Taipei, Taiwan  \nDear Editor,  \nWe thank Dr. Mahmood Al‑Mendalawi who has thoroughly read and raised his comments on our article titled “Aortic Aneurysm: Dissection from the Root to Pelvis,”[1] recently published in the January–March 2025 issue of the Journal of Medical Ultrasound.  \nDr. Al‑Mendalawi raised the concern of syphilis and its late consequences of vasculitis and vascular complications involving the cardiovascular system. We would like to provide additional demographic information. The patient described in our case had a national health registry medical record indicating no sexually transmitted diseases. We also listed the risk factors in the Discussion section (paragraph 2; page 65) . Numerous studies[2‑4] have revealed that the following factors contribute to aortic aneurysm dissection, listed in accordance with their prevalence and relevance: history of hypertension, prior aortic dissection, prior cardiac surgery, atherosclerosis, diabetes, smoking, chronic obstructive pulmonary disease, Marfan syndrome, and family history of aortic dissection. Aortic aneurysm, particularly in the thoracic aorta, is the main cardiovascular manifestation and is observed in 28%–54% of all patients with syphilis. Despite the presence of large aortic aneurysms, syphilitic aneurysms rarely dissect. [5] Patients with syphilis in Taiwan have access to free medical treatment and serological testing, which minimizes the likelihood of progression to tertiary syphilis.  \nReceived: 23‑04‑2025 Accepted: 02‑05‑2025 Available Online: 19‑12‑2025  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/jmut](https://journals.lww.com/jmut) |\n|  | DOI:\u003Cbr>10.4103/jmu.JMU‑D‑25‑00048 |\n\nIn conclusion, the effect of Marfan syndrome on aortic dissection in this case outweighed the contribution of syphilis.  \nFinancial support and sponsorship  \nResearch support grant from Chang Gung Memorial Hospital CMRPVVL0231 and CMRPVVN0091 .  \nConflicts of interest  \nThere are no conflicts of interest.  \nRefeRences  \n1. Jhang LS, Chao AS, Chien CW. Aortic aneurysm: Dissection from the root to pelvis. J Med Ultrasound 2025;33:64‑6 .  \n2. Harris KM, Nienaber CA, Peterson MD, Woznicki EM, BravermanAC, Trimarchi S, et al. Early mortality in type A acute aortic dissection: Insights from the International Registry of Acute Aortic Dissection. JAMA Cardiol 2022;7:1009‑15 .  \n3. Algodi M, Bustamante LS, Tauras J, Taub C. Syphilitic aortitis in late syphilis, diagnisus and treatment. JACC 2020;75:2736 .  \n4. Roberts WC, Roberts CS. Combined cardiovascular syphilis and type A acute aortic dissection. Am J Cardiol 2022;168:159‑62 .  \n5. Stansal A, Mirault T, Rossi A, Dupin N, Bruneval P, Bel A, et al. Recurrent tamponade and aortic dissection in syphilis. Ann Thorac Surg 2013;96:e111‑3 .  \nAddress for correspondence: Dr. An‑Shine Chao,  \nDepartment of Obstetrics and Gynecology, New Taipei Municipal Tucheng Hospital, 6, Sec. 2, Jin Cheng Road, Tucheng District, New Taipei 236, Taiwan.  \nE‑mail: [aschao1295@cgmh.org.tw](aschao1295@cgmh.org.tw)  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nFor reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.c","cbCaiqHSm8DUqMqp","https://ap.wps.com/l/cbCaiqHSm8DUqMqp","pdf",238006,"English","# Correspondence\n## Response to the editor’s comment\n## Risk factors and role of syphilis\n## Conclusion and disclosures","[{\"question\":\"What concern does the editor’s correspondent raise about the authors’ case?\",\"answer\":\"The correspondent raises concern about syphilis and its late consequences, including vasculitis and cardiovascular vascular complications.\"},{\"question\":\"How do the authors address whether syphilis was present in the patient?\",\"answer\":\"They report that the patient’s national health registry record indicated no sexually transmitted diseases, and they reference risk factors listed in their Discussion section.\"},{\"question\":\"What do the authors conclude about the dominant cause of the aortic dissection in this case?\",\"answer\":\"They conclude that the effect of Marfan syndrome outweighed the contribution of syphilis.\"}]","Reply to Comment on Aortic Aneurysm: Dissection from the Root to Pelvis | PDF",1790608886]