Sanky Charles, Sasi Nidhish
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Clin Exp Emerg Med. 2025 Mar;12(1):86-89. doi: 10.15441/ceem.23.182. Epub 2024 Mar 15.
This case concerns a 59-year-old male patient with a medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to immunoglobulin G4 (IgG4)-related disease, who was on chronic steroid treatment. The patient experienced acute onset of lightheadedness, a tingling sensation in both hands, and jaw tightness after masturbating. He was found to have type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease. This piece explores how the fibroinflammatory sequelae of IgG4-related disease can result in aortic manifestations and discusses the importance of considering a broader differential including aortic syndrome when encountering patients presenting with atypical symptoms.
该病例涉及一名59岁男性患者，有高血压、慢性肾功能不全病史，以及继发于免疫球蛋白G4（IgG4）相关疾病的自身免疫性胰腺炎，正在接受慢性类固醇治疗。该患者在自慰后出现急性头晕、双手刺痛感和下颌紧绷感。他被诊断为A型主动脉夹层。这是首例记录IgG4相关疾病患者出现非典型、无痛性主动脉夹层表现的病例。本文探讨了IgG4相关疾病的纤维炎症后遗症如何导致主动脉表现，并讨论了在遇到出现非典型症状的患者时考虑更广泛鉴别诊断（包括主动脉综合征）的重要性。
