両下肢浮腫にて発症した，IgG4関連疾患の関与が疑われた特発性後腹膜線維症による両側腸骨静脈狭窄に対し，ステント留置による血管内治療を施行した1例

Endovascular Treatment of Bilateral Iliac Vein Stenosis Due to Idiopathic Retroperitoneal Fibrosis Possibly Related to IgG4-related Diseases:A Case Report

要旨　症例は70歳の男性，1カ月ほど続く両下肢浮腫，疼痛と歩行困難にて紹介となった．造影CT検査を行ったところ，後腹膜腔広範に軟部陰影があり，骨盤内では両側総腸骨静脈から外腸骨静脈を取り巻くように存在し，両側腸骨静脈の狭小化を認めたため，特発性後腹膜線維症に伴う両側腸骨静脈狭窄と診断した．血液検査上IgG4の上昇がみられ，IgG4関連疾患包括診断基準にて疑診群であった．下肢症状による苦痛が強かったため，ステロイド治療に先立ち，即効性を期待しステント留置による血管内治療を行い，速やかな症状の改善が得られた．

　A 70-year-old man presented with bilateral leg edema, pain, and difficulty in ambulation. Enhanced computed tomography demonstrated stenosis of the bilateral iliac veins in the fibrous tissue that was surrounding the bilateral iliac veins. Because of the elevated serum IgG4 level, we diagnosed the condition as idiopathic retroperitoneal fibrosis with bilateral iliac vein stenosis, possibly related to IgG4-related diseases. Endovascular treatment was performed by bilateral iliac vein stent implantations prior to the administration of steroids because we considered it necessary to reduce the severity of the leg symptoms immediately. The leg symptoms promptly improved after the treatment.