A rare cause for lower back pain: a case of an IgG4-related periaortitis

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• 作者：Christian Löffler ; Johannes Hoffend ; Martin Rebel…
• 关键词：Aortitis ; Azathioprine ; IgG4 ; PET/CT ; Steroids ; Therapy
• 刊名：Clinical Rheumatology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：35
• 期：1
• 页码：265-270
• 全文大小：1,587 KB
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• 作者单位：Christian Löffler (1)
  Johannes Hoffend (2)
  Martin Rebel (3)
  Rüdiger Waldherr (4)
  Michael Uppenkamp (1)
  Raoul Bergner (1)
  
  1. Medizinische Klinik A, Klinikum Ludwigshafen, Ludwigshafen, Germany
  2. Klinik für diagnostische und interventionelle Radiologie, Klinikum Ludwigshafen, Ludwigshafen, Germany
  3. Institut für Pathologie, Klinikum Ludwigshafen, Ludwigshafen, Germany
  4. Institut für Pathologie und Zytologie, Prof. Waldherr, Heidelberg, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Rheumatology
  
• 出版者：Springer London
• ISSN：1434-9949

文摘

IgG4-related disease (IgG4-RD) are a group of autoinflammatory diseases often presenting as tumor-like lesions because of their infiltrative or mass forming behavior. They are characterized by a typical histology consisting of storiform fibrosis, high numbers of infiltrating IgG4-positive plasma cells, obliterative phlebitis, and a moderate presence of eosinophilic cells. Serum IgG4 levels can be elevated. We present a case of a 57 year-old male patient with immobilizing lower back pain, fever, and night sweats. We diagnosed IgG4-related periaortitis using serum IgG4 levels, abdominal ultrasound, PET/CT, and histology. We successfully treated the patient with glucocorticoids (GC) and azathioprine. Periaortitis is a rare presentation of IgG4-RD and therefore noteworthy. It has to be considered in patients with a retroperitoneal mass.