Journal
JOURNAL OF CLINICAL MEDICINE
Volume 12, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/jcm12124029
Keywords
abdominal aortic aneurysm; immunoglobulin G4; IgG4-related disease; inflammatory aneurysm
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This study investigates the histologic and serologic analyses of inflammatory and IgG4-positive abdominal aortic aneurysms (AAA), finding that the incidence of these subtypes is very low based on histologic and serum analyses. The degree of inflammation differs between the two subtypes, but no increased levels of IgG or IgG4 were found in the serologic analysis. Short-term operative outcomes were not different for both sub-cohorts.
Abdominal aortic aneurysms (AAA) are the most frequent aortic dilation, with considerable morbidity and mortality. Inflammatory (infl) and IgG4-positive AAAs represent specific subtypes of unclear incidence and clinical significance. Here, histologic and serologic analyses with retrospective clinical data acquisition are investigated via detailed histology, including morphologic (HE, EvG: inflammatory subtype, angiogenesis, and fibrosis) and immunhistochemic analyses (IgG and IgG4). In addition, complement factors C3/C4 and immunoglobulins IgG, IgG2, IgG4 and IgE were measured in serum samples and clinical data uses patients' metrics, as well as through semi-automated morphometric analysis (diameter, volume, angulation and vessel tortuosity). A total of 101 eligible patients showed five (5%) IgG4 positive (all scored 1) and seven (7%) inflammatory AAAs. An increased degree of inflammation was seen in IgG4 positive and inflAAA, respectively. However, serologic analysis revealed no increased levels of IgG or IgG4. The operative procedure time was not different for those cases and the short-term clinical outcomes were equal for the entire AAA cohort. Overall, the incidence of inflammatory and IgG4-positive AAA samples seems very low based on histologic and serum analyses. Both entities must be considered distinct disease phenotypes. Short-term operative outcomes were not different for both sub-cohorts.
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