ANEURISMA DE AORTA MEDIADA POR IGG4: PATOGÊNESE E ESTRATÉGIA TERAPÊUTICA
DOI:
https://doi.org/10.56238/arev8n2-066Palavras-chave:
Aneurisma, Aneurisma Aórtico, Aorta Abdominal, Doença Relacionada a Imunoglobulina G4Resumo
O Aneurisma de Aorta Abdominal (AAA) é uma condição inflamatória crônica multifatorial, associada ao elevado risco de mortalidade, principalmente em caso de ruptura. A Doença Relacionada a IgG4 (DR-IgG4) tem sido implicada na patogênese de aneurismas aórticos, especialmente nos casos de aortite e periaortite, nos quais há infiltração tecidual por plasmócitos IgG4+, fibrose estoriforme e flebite obliterante. Este estudo realizou uma revisão integrativa da literatura, com buscas feitas no PubMed, utilizando descritores relacionados a IgG4 e Aneurisma de Aorta Abdominal. Os resultados indicam que a DR-IgG4 afeta grandes vasos, como a aorta, podendo levar ao desenvolvimento de aneurismas inflamatórios, particularmente na região infra-abdominal. A patogênese inclui inflamação mediada por células da imunidade inata e adaptativa, ativação do sistema complemento, angiogênese, ação de citocinas como IL-6 e APRIL, além da formação de tecidos linfoides terciários na camada adventícia. A presença de adipócitos perivasculares também contribui para o processo inflamatório crônico. O tratamento é baseado em glicocorticoides, eficazes na indução da remissão, mas associados a efeitos adversos. Em casos refratários, utiliza-se imunossupressores ou terapias biológicas, como os anti-CD20. A compreensão do papel da IgG4 na patogênese do AAA permite maior precisão diagnóstica e pode favorecer abordagens terapêuticas personalizadas, contribuindo para a prevenção de complicações como a ruptura aneurismática. Destaca-se a necessidade de atenção clínica multidisciplinar e contínua atualização profissional frente a essa condição complexa e potencialmente fatal.
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