Modern tactic according to diagnostic and treatment of IgG4-associated abdominal aorta aneurysm
Abstract
IgG4-related diseases are geterogenic in organs involvement group of disoders characterized by elevated serum IgG4 level and morphologicaly presented with diffuse lymphoplasmacytic infiltration including IgG4-positive plasma cells, irregular fibrosis, and obliterative phlebitis. One of the manifestations of vascular IgG4-related diseases is an inflammatory abdominal aortic aneurysm (AAA). The development of specific morphological changes and proven effectiveness of immunosuppressive therapy should be considered in approaches to diagnosis and treatment strategy. However, today there are many questions in problem of IgG4-related diseases requiring their in-depth study.
Objective: to highlight the necessity to define the IgG4-associated abdominal aorta aneurysm as a separate nosological unit and to emphasize the role of histopathological studies as a basis for further researches and elaboration of clear diagnostic criteria and treatment algorithms.
Materials and methods: analysis of scientific data highlighting up-to-date approaches to understanding of etiology, pathogenesis, differential diagnosis and treatment strategy in case of IgG4-associated AAA.
Results and discussion. According to results of the literature review in case of IgG4-associated diseases the abdominal aorta may be involved in the pathological process as a part of systemic disease, as well as a separate nosological unit. Evaluation of biopsy material using immunohistochemical reactions in the case of inflammatory AAA plays a key role in determining the diagnosis and patients management one of the lines of which is administration of corticosteroids to improve the postoperative period.
Conclusions. Despite the lack of clear diagnostic criteria and treatment algorithms for IgG4-associated AAA, the results of histopathological study of biopsy specimens using specific immunohistochemical reactions play decisive role in the approach to patients management and creating statistical platform for further researches.
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