Aortic Valve Replacement Surgery Caused by IgG4-Related Aortic Regurgitation
DOI:
https://doi.org/10.59958/hsf.7879Keywords:
chronic autoimmune diseases, IgG4-related diseases, aortic valve disease, IgG4Abstract
While IgG4-related disease affects different organs, it is uncommon to associate it with the aortic valve. The clinical manifestations and prognosis of an uncommon IgG4-related aortic valve disease were examined by reporting it. After common activity, a 50-year-old man experienced shortness of breath and chest tightness. IgG4+ was expressed at a level of 4.23 g/L. The aortic valve had severe reflux, and the ascending aorta and aortic sinus were dilated, as evidenced by transesophageal echocardiography. Pathological results suggested that the ratio of IgG4+ cells to IgG+ cells was over 40%. Thus, the patient was diagnosed with aortic valve disease caused by IgG4+. Surgical treatment was executed. In clinical practice, IgG4-associated aortic regurgitation is uncommon and has the same clinical manifestations as general aortic valve disease. Nevertheless, there was a significant increase in serum IgG4+ levels. There was an association between the two. The pathology of valves can be proven.
References
Katz G, Stone JH. Clinical Perspectives on IgG4-Related Disease and Its Classification. Annual Review of Medicine. 2022; 73: 545–562.
Maritati F, Peyronel F, Vaglio A. IgG4-related disease: a clinical perspective. Rheumatology (Oxford, England). 2020; 59: iii123–iii131.
Peyronel F, Fenaroli P, Maritati F, Schleinitz N, Vaglio A. IgG4-related disease: advances in pathophysiology and treatment. Expert Review of Clinical Immunology. 2023; 19: 537–547.
Kubo S, Nakayamada S, Tanaka Y. Immunophenotype involved in IgG4-related disease. Modern Rheumatology. 2019; 29: 226–230.
Kamisawa T, Okazaki K. Diagnosis and Treatment of IgG4-Related Disease. Current Topics in Microbiology and Immunology. 2017; 401: 19–33.
Skillington SA, Ogden MA. IgG4-Related Disease and the Salivary Glands: A Review of Pathophysiology, Diagnosis, and Management. Otolaryngologic Clinics of North America. 2021; 54: 497–508.
Avincsal MO, Zen Y. The Histopathology of IgG4-Related Disease. Current Topics in Microbiology and Immunology. 2017; 401: 45–60.
Liu H, Wallace ZS, Harvey L, Crotty R, Wu CL, Deshpande V, et al. Prostate and pancreas involvement are linked in IgG4-related disease. Seminars in Arthritis and Rheumatism. 2020; 50: 1245–1251.
Tang M, Zhang Z, Wang L, Qian H, Wu W, Liu Z, et al. Coronary artery ectasia associated with IgG4-related disease: a case report and literature review. BMC Cardiovascular Disorders. 2023; 23: 347.
Chen YR, Yu SC, Wang RC, Lee CL, Song HL, Medeiros LJ, et al. Lymph Nodes With Increased IgG4-positive Plasma Cells and Patterns Suspicious for IgG4-related Disease: Can Lymph Nodes Be the Only Site of Disease? The American Journal of Surgical Pathology. 2023; 47: 387–396.
Abbas G, Karamchandani J, Ciarallo A, Durcan L. IgG4-Related Disease of the Central Nervous System: A Case Series. The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques. 2023; 50: 907–913.
Nomura S, Ishii W, Hara R, Nanasawa S, Nishiwaki K, Kagoshima M, et al. IgG4-related Disease with a Cardiac Mass Causing Cerebral Infarction. Internal Medicine (Tokyo, Japan). 2022; 61: 1259–1264.
Namba K, Sakai D, Mikamo H, Sugizaki Y, Sugiura Y, Hiruta N, et al. Serum IgG4-negative IgG4-related disease with a cardiac mass: A case report. Medicine. 2023; 102: e34533.
Published
How to Cite
Issue
Section
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
