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DOI: 10.1055/s-0044-1791566
CT Coronary Angiogram in Diagnosing IgG4 of Coronary Arteries Presenting as Acute Coronary Syndrome: A Case Report with Literature Review
Funding None.
Abstract
Immunoglobulin G4-related disease (IgG4 RD), first described in 2001, as a case of autoimmune pancreatitis, is a multisystemic condition, involving the salivary glands, bile ducts, pancreas, retroperitoneal organs, and mesentery and is associated with raised level of serum IgG4. Reports of coronary involvement by IgG4 RD are scarce and we could find only 16 case reports in the literature. Here, we present a case of a 61-year-old lady, with no known comorbidities, who presented with rapid progression of coronary artery stenosis. Initially, she presented with mild stenosis of left anterior descending which rapidly progressed to significant triple vessel disease in 3 months. Serological workup for antibodies was negative, except for raised serum IgG4 antibodies. She was managed effectively with steroids.
Keywords
coronary artery disease - Immunoglobulin G4-related disease - rapidly progressive coronary stenosisPatient Consent
The authors confirm that written consent for submission and publication of this case including images and associated text has been obtained from the patient in line with COPE guidance.
Authors' Contributions
The authors confirm contribution to the paper as follows: study conceptualization (J.V.), data collection and interpretation (A.R.C., J.V., S.S.), manuscript and figure preparation, manuscript revision based on feedback from coauthors (A.R.C., J.V., A.A.), supervision, manuscript critical revision (J.V., A.A., S.S.). All authors reviewed the results and approved the final version of the manuscript.
Publikationsverlauf
Artikel online veröffentlicht:
19. November 2024
© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Hamano H, Kawa S, Horiuchi A. et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001; 344 (10) 732-738
- 2 Oyama-Manabe N, Yabusaki S, Manabe O, Kato F, Kanno-Okada H, Kudo K. IgG4-related cardiovascular disease from the aorta to the coronary arteries: multidetector CT and PET/CT. Radiographics 2018; 38 (07) 1934-1948
- 3 Umehara H, Okazaki K, Kawa S. et al; Research Program for Intractable Disease by the Ministry of Health, Labor and Welfare (MHLW) Japan.. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD. Mod Rheumatol 2021; 31 (03) 529-533
- 4 Nishimura S, Amano M, Izumi C. et al. Multiple coronary artery aneurysms and thoracic aortitis associated with IgG4-related disease. Intern Med 2016; 55 (12) 1605-1609
- 5 Tanigawa J, Daimon M, Murai M, Katsumata T, Tsuji M, Ishizaka N. Immunoglobulin G4-related coronary periarteritis in a patient presenting with myocardial ischemia. Hum Pathol 2012; 43 (07) 1131-1134
- 6 Bito Y, Sasaki Y, Hirai H. et al. A surgical case of expanding bilateral coronary aneurysms regarded as immunoglobulin G4-related disease. Circulation 2014; 129 (16) e453-e456
- 7 Matsumoto Y, Kasashima S, Kawashima A. et al. A case of multiple immunoglobulin G4-related periarteritis: a tumorous lesion of the coronary artery and abdominal aortic aneurysm. Hum Pathol 2008; 39 (06) 975-980
- 8 Ikutomi M, Matsumura T, Iwata H. et al. Giant tumorous lesions (correction of legions) surrounding the right coronary artery associated with immunoglobulin-G4-related systemic disease. Cardiology 2011; 120 (01) 22-26
- 9 Tajima M, Hiroi Y, Takazawa Y. et al. Immunoglobulin G4-related multiple systemic aneurysms and splenic aneurysm rupture during steroid therapy. Hum Pathol 2014; 45 (01) 175-179
- 10 Inokuchi G, Hayakawa M, Kishimoto T, Makino Y, Iwase H. A suspected case of coronary periarteritis due to IgG4-related disease as a cause of ischemic heart disease. Forensic Sci Med Pathol 2014; 10 (01) 103-108
- 11 Urabe Y, Fujii T, Kurushima S, Tsujiyama S, Kihara Y. Pigs-in-a-blanket coronary arteries: a case of immunoglobulin G4-related coronary periarteritis assessed by computed tomography coronary angiography, intravascular ultrasound, and positron emission tomography. Circ Cardiovasc Imaging 2012; 5 (05) 685-687
- 12 Patel NR, Anzalone ML, Buja LM, Elghetany MT. Sudden cardiac death due to coronary artery involvement by IgG4-related disease: a rare, serious complication of a rare disease. Arch Pathol Lab Med 2014; 138 (06) 833-836
- 13 Guo Y, Ansdell D, Brouha S, Yen A. Coronary periarteritis in a patient with multi-organ IgG4-related disease. J Radiol Case Rep 2015; 9 (01) 1-17
- 14 Takei H, Nagasawa H, Sakai R. et al. A case of multiple giant coronary aneurysms and abdominal aortic aneurysm coexisting with IgG4-related disease. Intern Med 2012; 51 (08) 963-967
- 15 Keraliya AR, Murphy DJ, Aghayev A, Steigner ML. IgG4-related disease with coronary arteritis. Circ Cardiovasc Imaging 2016; 9 (03) e004583
- 16 Sakamoto A, Tanaka T, Hirano K, Koike K, Komuro I. Immunoglobulin G4- related coronary periarteritis and luminal stenosis in a patient with a history of autoimmune pancreatitis. Intern Med 2017; 56 (18) 2445-2450
- 17 Komiya Y, Soejima M, Tezuka D, Kohsaka H. Early detection and intervention of coronary artery involvement in immunoglobulin G4-related disease. Intern Med 2018; 57 (04) 617-622
- 18 Kan-o M, Kado Y, Sadanaga A, Tamiya S, Toyoshima S, Sakamoto M. Immunoglobulin G4-related multiple cardiovascular lesions successfully treated with a combination of open surgery and corticosteroid therapy. J Vasc Surg 2015; 61 (06) 1599-1603
- 19 Okuyama T, Tanaka TD, Nagoshi T, Yoshimura M. Coronary artery disease concomitant with immunoglobulin G4-related disease: a case report and literature review. Eur Heart J Case Rep 2019; 3 (01) ytz013
- 20 Accessed September 15, 2024 at: https://www.acc.org/Latest-in-Cardiology/Articles/2019/03/13/06/50/Vasculitis-of-the-Coronary-Arteries
- 21 Betrains A, Blockmans D. Diagnostic approaches for large vessel vasculitides. Open Access Rheumatol 2021; 13: 153-165
- 22 Dillon MJ, Eleftheriou D, Brogan PA. Medium-size-vessel vasculitis. Pediatr Nephrol 2010; 25 (09) 1641-1652
- 23 Quinaglia-Silva T, Medina F, Ramos CD, Coelho-Filho OR. Cardiac involvement in Erdheim-Chester disease. Circ Cardiovasc Imaging 2018; 11 (12) e008531