IgG4相关性主动脉周炎最初被怀疑为升主动脉壁内血肿。

IgG4-Related Periaortitis Initially Suspected of Being an Aortic Intramural Hematoma in the Ascending Aorta.

作者信息

Takahashi Kazuki, Kikuchi Shinsuke, Kamada Keisuke, Tochikubo Ai, Uchida Daiki, Koya Atsuhiro, Kamiya Hiroyuki, Azuma Nobuyoshi

机构信息

Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

出版信息

Ann Vasc Dis. 2021 Dec 25;14(4):380-383. doi: 10.3400/avd.cr.21-00024.

DOI:10.3400/avd.cr.21-00024

PMID:35082945

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8752925/

Abstract

Immunoglobulin G4-related disease (IgG4-RD) can affect various organs, including the cardiovascular system. In this study, we described the case of a 72-year-old man with periaortitis both in the ascending and terminal aorta related to IgG4-RD. He presented with swelling in the left leg. Computed tomography (CT) showed increased wall thickness of the ascending aorta and retroperitoneal fibrosis, which, in turn, caused deep vein thrombosis. Using positron emission tomography-computed tomography, the patient was diagnosed with IgG4-RD in the aorta. Although it was difficult to distinguish intramural hematoma (IMH) from IgG4-related periaortitis, treatment with steroids has dramatically improved his periaortitis. IgG4-related periaortitis should be differentiated from IMH due to their similar morphologies.

摘要

免疫球蛋白G4相关疾病（IgG4-RD）可累及包括心血管系统在内的多个器官。在本研究中，我们描述了一例72岁男性患者，其升主动脉和终末主动脉均发生与IgG4-RD相关的主动脉周炎。他表现为左腿肿胀。计算机断层扫描（CT）显示升主动脉壁厚度增加及腹膜后纤维化，进而导致深静脉血栓形成。通过正电子发射断层扫描-计算机断层扫描，该患者被诊断为主动脉IgG4-RD。尽管壁内血肿（IMH）与IgG4相关主动脉周炎难以区分，但使用类固醇治疗已显著改善了他的主动脉周炎。由于IgG4相关主动脉周炎和IMH形态相似，应加以鉴别。