IgG4-Related Periaortitis Initially Suspected of Being an Aortic Intramural Hematoma in the Ascending Aorta
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 to...
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| Published in | Annals of Vascular Diseases Vol. 14; no. 4; pp. 380 - 383 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The Editorial Committee of Annals of Vascular Diseases
25.12.2021
Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology |
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| Online Access | Get full text |
| ISSN | 1881-641X 1881-6428 1881-6428 |
| DOI | 10.3400/avd.cr.21-00024 |
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| 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. |
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| AbstractList | 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. 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.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. |
| ArticleNumber | cr.21-00024 |
| Author | Kikuchi, Shinsuke Tochikubo, Ai Azuma, Nobuyoshi Kamada, Keisuke Koya, Atsuhiro Uchida, Daiki Takahashi, Kazuki Kamiya, Hiroyuki |
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| Cites_doi | 10.1016/j.athoracsur.2011.03.141 10.1148/radiology.204.2.9240519 10.1056/NEJMra1104650 10.3748/wjg.v19.i1.35 10.1536/ihj.13-321 10.3400/avd.ra.18-00012 10.1161/CIRCULATIONAHA.111.084541 10.1016/j.humpath.2013.07.035 10.14744/AnatolJCardiol.2016.7185 10.1186/ar4671 |
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| Copyright | 2021 The Editorial Committee of Annals of Vascular Diseases. This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original. 2021 The Editorial Committee of Annals of Vascular Diseases. 2021 The Editorial Committee of Annals of Vascular Diseases. 2021 The Editorial Committee of Annals of Vascular Diseases. This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original. |
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| References | 3) Kasashima F, Kawakami K, Matsumoto Y, et al. IgG4-related arterial disease. Ann Vasc Dis 2018; 11: 72-7. 10) Tajima M, Hiroi Y, Takazawa Y, et al. Immunoglobulin G4-related multiple systemic aneurysms and splenic aneurysm rupture during steroid therapy. Hum Pathol 2014; 45: 175-9. 1) Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012; 366: 539-51. 6) Babur Güler G, Cantürk E, Güler E, et al. IgG4-related aortitis mimicking intramural hematoma. Anatol J Cardiol 2016; 16: 728-9. 9) Mizushima I, Inoue D, Yamamoto M, et al. Clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis: a retrospective multicenter study. Arthritis Res Ther 2014; 16: R156. 5) Byeon K, Han J, Kim JS, et al. Immunoglobulin G4-related periaortitis mimicking an intramural hematoma. Ann Thorac Surg 2011; 92: 1506-8. 4) Tajima M, Nagai R, Hiroi Y. IgG4-related cardiovascular disorders. Int Heart J 2014; 55: 287-95. 7) Harris KM, Braverman AC, Eagle KA, et al. Acute aortic intramural hematoma: an analysis from the International registry of acute aortic dissection. Circulation 2012; 126 Suppl 1: S91-6. 2) Fujimori N, Ito T, Igarashi H, et al. Retroperitoneal fibrosis associated with immunoglobulin G4-related disease. World J Gastroenterol 2013; 19: 35-41. 8) Murray JG, Manisali M, Flamm SD, et al. Intramural hematoma of the thoracic aorta: MR imaging findings and their prognostic implication. Radiology 1997; 204: 349-55. 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 5) Byeon K, Han J, Kim JS, et al. Immunoglobulin G4-related periaortitis mimicking an intramural hematoma. Ann Thorac Surg 2011; 92: 1506-8. – reference: 9) Mizushima I, Inoue D, Yamamoto M, et al. Clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis: a retrospective multicenter study. Arthritis Res Ther 2014; 16: R156. – reference: 8) Murray JG, Manisali M, Flamm SD, et al. Intramural hematoma of the thoracic aorta: MR imaging findings and their prognostic implication. Radiology 1997; 204: 349-55. – reference: 6) Babur Güler G, Cantürk E, Güler E, et al. IgG4-related aortitis mimicking intramural hematoma. Anatol J Cardiol 2016; 16: 728-9. – reference: 7) Harris KM, Braverman AC, Eagle KA, et al. Acute aortic intramural hematoma: an analysis from the International registry of acute aortic dissection. Circulation 2012; 126 Suppl 1: S91-6. – reference: 1) Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012; 366: 539-51. – reference: 2) Fujimori N, Ito T, Igarashi H, et al. Retroperitoneal fibrosis associated with immunoglobulin G4-related disease. World J Gastroenterol 2013; 19: 35-41. – reference: 10) Tajima M, Hiroi Y, Takazawa Y, et al. Immunoglobulin G4-related multiple systemic aneurysms and splenic aneurysm rupture during steroid therapy. Hum Pathol 2014; 45: 175-9. – reference: 3) Kasashima F, Kawakami K, Matsumoto Y, et al. IgG4-related arterial disease. Ann Vasc Dis 2018; 11: 72-7. – reference: 4) Tajima M, Nagai R, Hiroi Y. IgG4-related cardiovascular disorders. Int Heart J 2014; 55: 287-95. – ident: 5 doi: 10.1016/j.athoracsur.2011.03.141 – ident: 8 doi: 10.1148/radiology.204.2.9240519 – ident: 1 doi: 10.1056/NEJMra1104650 – ident: 2 doi: 10.3748/wjg.v19.i1.35 – ident: 4 doi: 10.1536/ihj.13-321 – ident: 3 doi: 10.3400/avd.ra.18-00012 – ident: 7 doi: 10.1161/CIRCULATIONAHA.111.084541 – ident: 10 doi: 10.1016/j.humpath.2013.07.035 – ident: 6 doi: 10.14744/AnatolJCardiol.2016.7185 – ident: 9 doi: 10.1186/ar4671 |
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| Title | IgG4-Related Periaortitis Initially Suspected of Being an Aortic Intramural Hematoma in the Ascending Aorta |
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