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

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Abstract

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.

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Authors and Affiliations

  1. Medizinische Klinik A, Klinikum Ludwigshafen, Ludwigshafen, Germany

    Christian Löffler, Michael Uppenkamp & Raoul Bergner

  2. Klinik für diagnostische und interventionelle Radiologie, Klinikum Ludwigshafen, Ludwigshafen, Germany

    Johannes Hoffend

  3. Institut für Pathologie, Klinikum Ludwigshafen, Ludwigshafen, Germany

    Martin Rebel

  4. Institut für Pathologie und Zytologie, Prof. Waldherr, Heidelberg, Germany

    Rüdiger Waldherr

Authors
  1. Christian Löffler
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  2. Johannes Hoffend
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  3. Martin Rebel
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  4. Rüdiger Waldherr
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  5. Michael Uppenkamp
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  6. Raoul Bergner
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Correspondence to Christian Löffler.

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Löffler, C., Hoffend, J., Rebel, M. et al. A rare cause for lower back pain: a case of an IgG4-related periaortitis. Clin Rheumatol 35, 265–270 (2016). https://doi.org/10.1007/s10067-014-2535-0

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  • DOI: https://doi.org/10.1007/s10067-014-2535-0

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