Clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis: a retrospective multicenter study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-07-23

AUTHORS

Ichiro Mizushima, Dai Inoue, Motohisa Yamamoto, Kazunori Yamada, Takako Saeki, Yoshifumi Ubara, Shoko Matsui, Yasufumi Masaki, Takashi Wada, Satomi Kasashima, Kenichi Harada, Hiroki Takahashi, Kenji Notohara, Yasuni Nakanuma, Hisanori Umehara, Masakazu Yamagishi, Mitsuhiro Kawano

ABSTRACT

IntroductionImmunoglobulin G4 (IgG4)–related aortitis/periaortitis and periarteritis are vascular manifestations of IgG4-related disease. In this disease, the affected aneurysmal lesion has been suspected to be at risk of rupture. In this study, we aimed to clarify the clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis.MethodsWe retrospectively evaluated clinical features, including laboratory data, imaging findings and the course after corticosteroid therapy, in 40 patients diagnosed with IgG4-related aortitis/periaortitis and periarteritis on the basis of periaortic/periarterial radiological findings, satisfaction of the comprehensive diagnostic criteria or each organ-specific diagnostic criteria, and exclusion of other diseases.ResultsThe patients were mainly elderly, with an average age of 66.4 years and with a marked male predominance and extensive other organ involvement. Subjective symptoms were scanty, and only a small proportion had elevated serum C-reactive protein levels. The affected aorta/artery were the abdominal aortas or the iliac arteries in most cases. Thirty-six patients were treated with prednisolone, and the periaortic/periarterial lesions improved in most of them during the follow-up period. Two (50.0%) of four patients with luminal dilatation of the affected lesions before corticosteroid therapy had exacerbations of luminal dilatation after therapy, whereas none of the twenty-six patients without it had a new appearance of luminal dilatation after therapy.ConclusionsThe results of this retrospective multicenter study highlight three important points: (1) the possibility of latent existence and progression of periaortic/periarterial lesions, (2) the efficacy of corticosteroid therapy in preventing new aneurysm formation in patients without luminal dilatation of periaortic/periarterial lesions and (3) the possibility that a small proportion of patients may actually develop luminal dilatation of periaortic/periarterial lesions in IgG4-related aortitis/periaortitis and periarteritis. A larger-scale prospective study is required to confirm the efficacy and safety of corticosteroid therapy in patients with versus those without luminal dilatation and to devise a more useful and safe treatment strategy, including administration of other immunosuppressants. More... »

PAGES

r156

Journal

TITLE

Arthritis Research & Therapy

ISSUE

4

VOLUME

16

Author Affiliations

  • Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, 920-8640, Kanazawa Ishikawa, Japan
  • Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, 920-8640, Kanazawa, Ishikawa, Japan
  • The First Department of Internal Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Hokkaido, Japan
  • Department of Internal Medicine, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, 940-2085, Niigata, Japan
  • Nephrology Center, Toranomon Hospital, 1-3-1 Kajigaya, Takatsu, Kawasaki, 212-0015, Kanagawa, Japan
  • Health Administration Center, Sugitani Campus, University of Toyama, 2630 Sugitani, Toyama-shi, 930-0194, Toyama, Japan
  • Department of Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahokugun, 920-0293, Ishikawa, Japan
  • Division of Nephrology, Department of Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
  • Department of Pathology and Clinical Laboratory, National Hospital Organization, Kanazawa Medical Center, 1-1 Shimoisibikimachi, 920-8650, Kanazawa, Ishikawa, Japan
  • Department of Human Pathology, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, 920-8640, Kanazawa, Ishikawa, Japan
  • Department of Pathology, Kurashiki Central Hospital, Miwa, Kurashiki, 710-8602, Okayama, Japan
  • Division of Cardiology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/ar4671

    DOI

    http://dx.doi.org/10.1186/ar4671

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1045741487

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/25056443


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