Immunoglobulin G4-related masses surrounding coronary arteries: a case report.

European Heart Journal. Case Reports
Takuya NakamuraHiroyuki Kawata

Abstract

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with high serum IgG4 levels affecting various organs, such as the pancreas, lacrimal and salivary glands, thyroid, kidney, and lung. Typical cardiovascular manifestations of IgG4-RD include periaortitis, coronary arteritis, and pericarditis. However, reports of IgG4-RD associated with coronary arteritis are rare. Here, we report a case of IgG4-related masses surrounding the coronary arteries. A 59-year-old man was referred to our hospital because of mediastinal masses detected by computed tomography (CT). Coronary CT angiography revealed masses surrounding the right coronary artery and the left anterior descending coronary artery. An elevated serum level of IgG4 and histological findings led to the diagnosis of IgG4-related coronary arteritis with mass formation. Coronary angiography showed numerous feeding arteries to the masses, which were demonstrated as multiple microchannels in the intravascular ultrasound (IVUS) images. IgG4-RD involving the cardiovascular system has been reported. However, coronary artery disease associated with IgG4-RD is very rare, and the mechanism of mass formation in IgG4-related coronary arteritis i...Continue Reading

References

Aug 4, 2010·Journal of Vascular Surgery·Satomi KasashimaYasuni Nakanuma
Feb 10, 2012·The New England Journal of Medicine·John H StoneVikram Deshpande
Jun 6, 2014·International Heart Journal·Miyu TajimaYukio Hiroi
Jun 6, 2015·The Annals of Thoracic Surgery·Kazutoshi HamanakaToshitsugu Nakamura
Aug 22, 2015·International Journal of Cardiology·Mai N TranGregory M Scalia
Jan 18, 2019·Current Cardiology Reviews·Ahmed Fathala
Mar 1, 2019·Arteriosclerosis, Thrombosis, and Vascular Biology·Hirokazu AmamizuHiroaki Shimokawa
Dec 4, 2019·Arthritis & Rheumatology·Zachary S WallaceUNKNOWN American College of Rheumatology/European League Against Rheumatism IgG4-Related Disease Classification Criteria Working Gro

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