Mass lesions surrounding coronary artery associated with immunoglobulin G4-related disease

Abstract

Immunoglobulin G4 (IgG4)-related diseases have been reported to be systemic diseases characterized by elevation of serum IgG4 concentration and infiltration of IgG4-positive plasma cells within the target organ. However, the involvement of coronary artery is very rare. Here, we report a 62-year-old man with mass lesions surrounding coronary artery and abdominal aorta associated with IgG4-related disease diagnosed by a needle biopsy of the mass lesion surrounding the coronary artery using echocardiography and computed tomography. After we started to treat the patient with prednisolone, his serum IgG4 level decreased, and the mass lesions of coronary and abdominal artery were markedly reduced in size after 4 months. In conclusion, IgG4-related disease should be considered in addition to tumors such as malignant lymphoma when mass lesions surrounding coronary artery are detected.

Outcome of Long-term Maintenance Steroid Therapy Cessation in Patients With Autoimmune Pancreatitis

“…(5) Coronary artery lesions (coronary periarteritis) were diagnosed when computed tomography (CT) angiography showed (1) one or more homogeneous nodular lesions or pseudotumors along the coronary artery walls; or (2) rinds of soft tissue surrounding the coronary arteries. [13][14][15][16][17][18][19] (6) ST was also resumed if Z2 lesions appeared, even when the individual lesions were not a sufficient indication based on the aforementioned criteria. Several steroid-reactive diseases are often associated with but may not necessarily be IgG4 RD (eg, bronchial asthma, arthralgia, and thrombocytopenia).…”

Successful treatment of primary cardiac lymphoma causing ST-elevation myocardial infarction by percutaneous coronary intervention combined with chemotherapy

“…Although most cases of acute myocardial infarction are caused by plaque rupture and/or the presence of thrombi in the coronary arteries, in the present case, intravascular ultrasound revealed no atheromatous plaque in the coronary arteries and demonstrated that the lumen narrowing was not caused by the thrombus, but was caused instead by the surrounding tumour mass, the expansion of which impaired the coronary flow, thereby inducing myocardial ischaemia (figure 2C). Immunoglobulin G4-related disease is also a common cause of lesions surrounding the coronary arteries;9 however, this abnormality was excluded based on histology in the present case. The prevalence of PCL is currently increasing due to advancements in imaging modalities and a growing population of immunocompromised patients.…”

Association between serum IgG4 concentrations and the morphology of the aorta in patients who undergo cardiac computed tomography

“…For example, Debonnaire et al [25] reported a case of giant coronary artery aneurysm that was diagnosed as IgG4-related disease by kidney biopsy. In addition, Kusumoto et al [26] reported a patient with mass lesions surrounding both the coronary artery and abdominal aorta that were associated with IgG4-related disease as diagnosed by a needle biopsy. Furthermore, we have recently shown that serum concentrations of IgG4 were significantly higher in patients with CAD than in those without [27].…”