Surgical procedure in immunoglobulin G4-related ascending aortitis?
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.
Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: sebastien.colombier@chuv.ch.
Sébastien
S
Colombier
Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
Patrick
P
Ruchat
Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
Fabrizio
F
Gronchi
Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
René
R
Prêtre
Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
Lars
L
Niclauss
D001011:Aorta / Q000601:surgery*; D001025:Aortitis / Q000276:immunology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G; D008875:Middle Aged
D007074:Immunoglobulin G