Endovascular Repair of a False Aneurysm Developing from IgG4-Related Periaortitis during Corticosteroid Therapy

Ann Vasc Surg. 2015 Oct;29(7):1452.e5-9. doi: 10.1016/j.avsg.2015.04.070. Epub 2015 Jun 26.

Abstract

Immunoglobulin G4 (IgG4)-related disease is a systemic autoimmune disease that can affect various organs. Corticosteroid therapy is generally an effective treatment; however, IgG4-related aortic lesions pose a risk of aortic rupture related to corticosteroid use. Here, we report a case of IgG4-related periaortitis complicated with a false aneurysm during corticosteroid therapy. Although endovascular repair was successfully performed, autoimmune pancreatitis and sclerosing cholangitis emerged after surgery. The multiple lesions associated with IgG4-related disease were resolved through continuous corticosteroid therapy. Our case suggests that both appropriate surgical intervention and continuous corticosteroid therapy are essential for the treatment of IgG4-related periaortitis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Aged
  • Aneurysm, False / diagnosis
  • Aneurysm, False / immunology
  • Aneurysm, False / surgery*
  • Aortic Aneurysm / diagnosis
  • Aortic Aneurysm / immunology
  • Aortic Aneurysm / surgery*
  • Aortography / methods
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / drug therapy*
  • Autoimmune Diseases / immunology
  • Blood Vessel Prosthesis Implantation*
  • Cholangitis, Sclerosing / immunology
  • Endovascular Procedures*
  • Female
  • Humans
  • Immunoglobulin G / immunology*
  • Pancreatitis / immunology
  • Retroperitoneal Fibrosis / complications
  • Retroperitoneal Fibrosis / diagnosis
  • Retroperitoneal Fibrosis / drug therapy*
  • Retroperitoneal Fibrosis / immunology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin G