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Case Reports in Vascular Medicine
Volume 2019, Article ID 8249061, 7 pages
https://doi.org/10.1155/2019/8249061
Case Report

Rare Clinical Course of Immunoglobulin G4-Related Inflammatory Abdominal Aortic Aneurysm with Multiple Rare Complications

1Department of Thoracic Surgery, Asahikawa City Hospital, Asahikawa, Japan
2Department of Cardiovascular Surgery, Hokko Memorial Hospital, Sapporo, Japan
3Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
4Department of Internal Medicine, Fukagawa Municipal Hospital, Fukagawa, Japan
5Department of Pathology, Asahikawa City Hospital, Asahikawa, Japan
6Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan
7Department of Pathology, Asahikawa Red Cross Hospital, Asahikawa, Japan
8Department of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan

Correspondence should be addressed to Tsukasa Miyatake; pj.oc.oohay@katayimt

Received 11 March 2019; Accepted 21 May 2019; Published 3 June 2019

Academic Editor: Konstantinos A. Filis

Copyright © 2019 Yuji Naito et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Immunoglobulin G4- (IgG4-) related inflammatory abdominal aortic aneurysm (AAA) has been recognized as a manifestation of IgG4-related disease (IgG4-RD). We experienced one patient with multiple consecutive manifestations before and after endovascular stent grafting for IgG4-related inflammatory AAA (IAAA). A 71-year-old man was diagnosed with IgG4-RD due to increased IgG4 serum concentration, typical findings of parotid gland biopsy, and periaortitis in another hospital 2 years and 7 months before visiting our hospital. He came to our hospital because of abdominal pain and IAAA. He developed paraplegia after hospitalization and underwent endovascular stent grafting for the IAAA. About one month after stent grafting, he developed perforation of the sigmoid colon due to enteritis. He also had myocardial infarction. Finally, he died of intestinal bleeding. Here, we describe this case with rare, multiple, consecutive manifestations of IgG4-RD, some of which might be caused by IgG4-related IAAA or side effects of treatments rather than by IgG4-RD itself. We report this case because the clinical course seemed rare for IgG4-RD or IgG4-related IAAA. For treating IgG4-RD with IgG4-related IAAA, we should consider factors causing the symptoms and carefully select the proper treatment.