title: Carotid aneurism with acute dissection: an unusual case of IgG4-related diseases.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Neurosciences NPSRR, University of Padova, Padova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barp
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. Electronic address: marny.fedrigo@sanita.padova.it.
authors.forename: Marny
authors.initials: M
authors.lastname: Fedrigo
authors.affiliation: Department of Neurosciences NPSRR, University of Padova, Padova, Italy.
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Farina
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Lepidi
authors.affiliation: Department of Medicine, Radiology Institute, University of Padova, Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Causin
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Castellani
authors.affiliation: Department of Medicine, Radiology Institute, University of Padova, Padova, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Cester
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Valente
authors.affiliation: Department of Neurosciences NPSRR, University of Padova, Padova, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Baracchini
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Angelini
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D017541:Aneurysm, False / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002340:Carotid Artery Diseases / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G
keywords: Carotid dissection; IgG4-related disease