Ikeoka Kuniyasu, Watanabe Tetsuya, Ohkawa Toshika, Tsuzuki Takashi, Ikeda Yoshihiko, Takeda Masashi, Hoshida Shiro
Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan.
Department of Neurosurgery, Yao Municipal Hospital, Osaka, Japan.
J Vasc Surg Cases Innov Tech. 2019 Jun 29;5(3):289-292. doi: 10.1016/j.jvscit.2019.03.019. eCollection 2019 Sep.
Mikulicz's disease is one of the IgG4-related diseases (IgG4-RDs) that involves the cardiovascular system; however, small-sized vasculitis is rare in IgG4-related diseases. A 64-year-old man presented with distal occlusive disease and developed left cerebrovascular infarction with occlusion of the middle cerebral artery and diseased temporal artery branches. He underwent superficial temporal artery-middle cerebral artery anastomosis surgery. Histology of the temporal artery biopsy showed smooth muscle cell proliferation with many IgG4-positive plasma cells. He then developed salivary gland inflammation, and Mikulicz's disease was diagnosed. Small-sized occlusive vasculitis was observed in this IgG4-RD. Low-dose corticosteroid therapy is effective in preventing progressive occlusive disease.
米库利奇病是累及心血管系统的IgG4相关疾病（IgG4-RD）之一；然而，小血管炎在IgG4相关疾病中较为罕见。一名64岁男性出现远端闭塞性疾病，并因大脑中动脉闭塞和颞动脉分支病变而发生左侧脑血管梗死。他接受了颞浅动脉-大脑中动脉吻合手术。颞动脉活检的组织学检查显示平滑肌细胞增殖，伴有许多IgG4阳性浆细胞。随后他出现了唾液腺炎症，并被诊断为米库利奇病。在这种IgG4-RD中观察到了小血管闭塞性血管炎。低剂量皮质类固醇治疗可有效预防进行性闭塞性疾病。
