Carotid aneurism with acute dissection: an unusual case of IgG4-related diseases

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• 作者：Andrea Barp^a ; Marny Fedrigo^b ; ^{marny.fedrigo@sanita.padova.it" class="auth_mail" title="E-mail the corresponding author} ; Filippo Maria Farina^a ; Sandro Lepidi^b ; Francesco Causin^c ; Chiara Castellani^b ; Giacomo Cester^c ; Gaetano Thiene^b ; Marialuisa Valente^b ; Claudio Baracchini^a ; Annalisa Angelini^b
• 关键词：IgG4-related disease ; Carotid dissection
• 刊名：Cardiovascular Pathology
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：25
• 期：1
• 页码：59-62
• 全文大小：824 K

文摘

IgG4-related disease is a systemic disease that involves organs and vascular structures, in particular, the aorta. This is the first case that showed the carotid artery involvement with dissection evolution.

Methods and Results

In a 67-year-old man with speech impairment and right-hand clumsiness, a brain computed tomography revealed signs of acute ischemia in the left frontal lobe while an echo-color Doppler sonography of the cervical vessels showed a tight stenosis of left internal carotid artery with a large pseudoaneurysm. Histological findings performed on the surgical specimen disclosed IgG4-related disease.

Conclusions

To the best of our knowledge, this is the first manifestation of IgG4-related disease with carotid artery dissection complicated by pseudoaneurysm. Even though unsuccessful since the patients died within 48 h, this case highlights the diverse facets of the IgG4-related disease representing a new complication with important clinical implications of such a diagnosis targeting immunosuppressive therapy particularly B-cell depletion.