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doi: https://doi.org/10.15441/ceem.23.182    [Accepted]
Masturbation-induced presyncope: a case report of painless aortic dissection in immunoglobulin G4-related disease
Charles Sanky , Nidhish Sasi
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Correspondence  Charles Sanky Email: charles.sanky@mountsinai.org
Received: December 28, 2023. Revised: February 21, 2024.  Accepted: March 2, 2024. Published online: March 15, 2024.
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 while 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.
Keywords: Immunoglobulin G4-related disease; Aortic dissection; Presyncope; Masturbation; Case reports
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