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The many faces of IgG4-related disease: report of a case with inaugural recurrent aortic aneurism ruptures and literature review

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Abstract

Vascular involvement in IgG4-related disease (IgG4-RD), is a well-recognized feature and large vessel commitment, especially the aorta, can be the only manifestation of the disease. Being a newly recognized disease, its diagnosis and workup still represents a challenge in clinical practice. A 47-year-old-man with two aortic aneurysms ruptures, one at abdominal and the other at thoracic level, was referred to our rheumatology department. The initial analysis of the surgical specimen obtained 3 years earlier revealed a nonspecific aortitis. Re-evaluation of the biopsy with immunohistology now demonstrated the presence of IgG4 deposits. Evidence-based recommendations regarding diagnosis, treatment and follow-up of IgG4-related large-vessel involvement are lacking. In this particular case, histopathology were crucial. The authors review and discuss vascular involvement in IgG4-RD and respective treatment options.

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Author notes

  1. Mariana Luís and Luísa Brites equally contributed to the investigations and written this case report.

Authors and Affiliations

  1. Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Mariana Luís, Luísa Brites, Diogo Jesus, Tânia Santiago, Sara Serra, João Rovisco, José António P. da Silva & Armando Malcata

  2. Anatomical Pathology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Bruno Fernandes & Lina Carvalho

Authors
  1. Mariana Luís
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Contributions

M. L. and L.B. conceived of the presented idea; D.J., T.S., S.S. and J.R. participated in the literature review; B.F. and L.C. performed the histological work and contributed to the histopathological-related literature review; J.A.P.S. and A.M. supervised the findings of this work; All authors discussed the results and contributed to the final manuscript.

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Correspondence to Mariana Luís.

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Mariana Luís, Luisa Brites, Bruno Fernandes, Diogo Jesus, Tânia Santiago, Sara Serra, João Rovisco, Lina Carvalho, José António P. da Silva and Armando Malcata declare that they have no conflict of interest.

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Luís, M., Brites, L., Fernandes, B. et al. The many faces of IgG4-related disease: report of a case with inaugural recurrent aortic aneurism ruptures and literature review. Rheumatol Int 38, 1565–1570 (2018). https://doi.org/10.1007/s00296-018-4046-9

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  • DOI: https://doi.org/10.1007/s00296-018-4046-9

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