1. Surgical Procedure in Immunoglobulin G4–Related Ascending Aortitis?
- Author
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Sébastien Colombier, Fabrizio Gronchi, Lars Niclauss, Patrick Ruchat, and René Prêtre
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Systemic disease ,Aortic aneurysm ,Immunoglobulin g4 ,medicine.artery ,parasitic diseases ,medicine ,Humans ,Thoracic aorta ,Inner diameter ,Aorta ,Aortitis ,business.industry ,Middle Aged ,medicine.disease ,Aortic wall ,Surgery ,Immunoglobulin G ,cardiovascular system ,Female ,Thickening ,Cardiology and Cardiovascular Medicine ,business - Abstract
Immunoglobulin G4 (IgG4)-related fibroinflammatory systemic disease accounts for 7% of all noninfectious aneurysms of the thoracic aorta. A patient was admitted with a symptomatic ascending aortic aneurysm and thickened aortic wall (outer/inner diameter 55/45 mm), which was replaced. Probes revealed IgG4-related aortitis associated with a primary tuberculosis infection. Corticosteroid and antituberculosis therapies were used, and the patient's clinical evolution was favorable. The optimal treatment strategy of IgG4-related aortitis, a new entity, remains vague. Inner aortic diameter alone does not justify aortic replacement, but wall thickening may mimic intramural hematoma. In this particular case of IgG4-related aortitis, immunosuppressive treatment alone, as an alternative to a surgical procedure, may be debatable.
- Published
- 2014
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