Masturbation-induced presyncope: a case report of painless aortic dissection in immunoglobulin G4-related disease

手淫诱发晕厥前兆:一例免疫球蛋白G4相关疾病引起的无痛性主动脉夹层病例报告

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Abstract

This case concerns a 59-year-old male patient with a medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to immunoglobulin G4 (IgG4)-related disease, who was on chronic steroid treatment. The patient experienced acute onset of lightheadedness, a tingling sensation in both hands, and jaw tightness after masturbating. He was found to have type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease. This piece explores how the fibroinflammatory sequelae of IgG4-related disease can result in aortic manifestations and discusses the importance of considering a broader differential including aortic syndrome when encountering patients presenting with atypical symptoms.

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