IgG4-related small-sized occlusive vasculitis in Mikulicz's disease.

• 发表时间: Sep 2019
• 来源期刊: J Vasc Surg Cases Innov Tech
• DOI: 10.1016/j.jvscit.2019.03.019
• PMID: 31334401
• 文章类型: Case Reports
• 作者列表: Ikeoka K,Watanabe T,Ohkawa T,Tsuzuki T,Ikeda Y,Takeda M,Hoshida S

关键词: Cerebral infarction; Endovascular therapy; IgG4-related disease; Mikulicz’s disease; Small-sized vasculitis

Abstract

Mikulicz\'s disease is one of the IgG4-related diseases (IgG4-RDs) that involves the cardiovascular system; however, small-sized vasculitis is rare in IgG4-related diseases. A 64-year-old man presented with distal occlusive disease and developed left cerebrovascular infarction with occlusion of the middle cerebral artery and diseased temporal artery branches. He underwent superficial temporal artery-middle cerebral artery anastomosis surgery. Histology of the temporal artery biopsy showed smooth muscle cell proliferation with many IgG4-positive plasma cells. He then developed salivary gland inflammation, and Mikulicz\'s disease was diagnosed. Small-sized occlusive vasculitis was observed in this IgG4-RD. Low-dose corticosteroid therapy is effective in preventing progressive occlusive disease.