Carotid aneurism with acute dissection: An unusual case of IgG4-related diseases

11noAim: IgG4-related disease is a systemic disease that involves organs and vascular structures, in particular, the aorta. This is the first case that showed the carotid artery involvement with dissection evolution. Methods and Results: In a 67-year-oldman with speech impairment and right-hand clumsiness, a brain computed tomography revealed signs of acute ischemia in the left frontal lobe while an echo-color Doppler sonography of the cervical vessels showed a tight stenosis of left internal carotid artery with a large pseudoaneurysm. Histological findings performed on the surgical specimen disclosed IgG4-related disease. Conclusions: To the best of our knowledge, this is the first manifestation of IgG4-related disease with carotid artery dissection complicated by pseudoaneurysm. Even though unsuccessful since the patients died within 48 h, this case highlights the diverse facets of the IgG4-related disease representing a new complication with important clinical implications of such a diagnosis targeting immunosuppressive therapy particularly B-cell depletion.reservedmixedBarp A.; Fedrigo M.; Farina F.M.; Lepidi S.; Causin F.; Castellani C.; Cester G.; Thiene G.; Valente M.; Baracchini C.; Angelini A.Barp, A.; Fedrigo, M.; Farina, F. M.; Lepidi, S.; Causin, F.; Castellani, C.; Cester, G.; Thiene, G.; Valente, M.; Baracchini, C.; Angelini, A