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, 12 (4), 545-547

A Case of Ruptured Immunoglobulin G4-Related Periaortitis

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A Case of Ruptured Immunoglobulin G4-Related Periaortitis

Masahiko Hasegawa et al. Ann Vasc Dis.

Abstract

An 80-year-old man had high serum immunoglobulin G4 (IgG4) concentration and fibrous thickening of the soft tissue mass surrounding the region from the abdominal aorta to the bilateral iliac arteries, suggestive of IgG4-related periaortitis. He presented to our emergency department with sudden-onset abdominal pain and lumbago. Computed tomography revealed a ruptured abdominal aorta. He was a poor candidate for open surgery due to his hostile abdomen. Therefore, endovascular aneurysm repair was performed. No consensus about the surgical indication for IgG4-related arterial disease has been reached yet. We believe that a novel indicator is needed for this disease.

Keywords: aortic disease; endovascular surgery; inflammatory abdominal aortic aneurysm.

Conflict of interest statement

Disclosure StatementThe authors declare no conflicts of interest associated with this manuscript.

Figures

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Fig. 1 Contrast-enhanced computed tomography (CECT) images 6 months prior to the rupture. (AD) Sections of the axial CECT images. (BD) The levels of the lines in (E). (E) Multiplanar reconstruction image.
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Fig. 2 Contrast-enhanced computed tomography (CECT) images at the time of the rupture. (AC) Sections of the axial CECT scan images. (AC) The levels of the lines in (D). (D) Three-dimensional CT image.
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Fig. 3 Contrast-enhanced computed tomography (CECT) images 1 year following the initiation of steroid therapy. (AD) Sections of the axial CECT scan images. (BD) The levels of the lines in (E). (E) Multiplanar reconstruction image. The axial slice levels in (A) through (D) are about the same height as the axial slice levels in (A) through (D) in Fig. 1.

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References

    1. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012; 366: 539-51. - PubMed
    1. Kasashima S, Kawashima A, Kasashima F, et al. Immunoglobulin G4-related periaortitis complicated by aortic rupture and aortoduodenal fistula after endovascular AAA repair. J Endovasc Ther 2014; 21: 589-97. - PubMed
    1. Hamano H, Kawa S, Horiuchi A, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001; 344: 732-8. - PubMed
    1. Kasashima S, Zen Y, Kawashima A, et al. Inflammatory abdominal aortic aneurysm: close relationship to IgG4-related periaortitis. Am J Surg Pathol 2008; 32: 197-204. - PubMed
    1. Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol 2012; 22: 21-30. - PubMed
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