CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Tocilizumab in the Treatment of IgG4-Related Disease Involving the Carotid Artery-Case Report and Literature Review
Provisionally accepted
- 1Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 2Nursing Department，Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China, Hangzhou, China
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IgG4-related disease (IgG4-RD) is an autoimmune disorder characterized by fibroinflammatory infiltration of affected organs. This systemic condition can involve multiple organs, including the pancreas, bile ducts, salivary glands, kidneys and lungs. However, IgG4-related disease demonstrates substantial heterogeneity and frequently involves atypical anatomical sites, leading to frequent clinical misdiagnosis.We report a rare case of IgG4-RD involving the carotid artery and vagus nerve, presenting with hoarseness and syncope. Diagnosis was confirmed via contrast-enhanced neck MRI and carotid artery biopsy. The patient exhibited poor response to glucocorticoids and methotrexate but achieved sustained remission following combination therapy with tocilizumab. A literature review revealed that isolated involvement of the carotid artery and vagus nerve in IgG4-RD is exceptionally rare.
Keywords: carotid artery, Glucocorticoids, IgG4-related disease, tocilizumab, Vagus Nerve
Received: 29 Oct 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Ding, Tao, Xu and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yongmei Han
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