Document Detail


Giant Tumorous Legions Surrounding the Right Coronary Artery Associated with Immunoglobulin-G4-Related Systemic Disease.
MedLine Citation:
PMID:  22094884     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Immunoglobulin G4 (IgG4)-related systemic disease was first recognized as a clinicopathological entity about 10 years ago, and since then, it has attracted growing attention. It is an autoimmune disease which affects multiple organs including the pancreas, bile duct, salivary glands and retroperitoneum. Further, it was recently reported that it can be manifested as periarteritis, often as inflammatory abdominal aortic aneurysm. We describe the case of a 75-year-old man with autoimmune pancreatitis and parotitis who presented with angina. The serum concentration of IgG4 was significantly increased at 2,510 mg/dl. Coronary angiography showed multiple stenotic lesions and pronounced dilatation of the right coronary artery. Cardiac computed tomography disclosed increased wall thickness of the coronary arteries and focal tumorous lesions surrounding the right coronary artery. Treatment with steroids proved only marginally effective and he underwent surgical resection of the aneurysm and coronary artery bypass grafting. The diagnosis of IgG4-related systemic disease was confirmed by histological examination of the resected mass, which showed a massive infiltration of IgG4-positive plasma cells. This case emphasizes the importance of considering the diagnosis in any patient with abnormally increased wall thickness or ectatic lesions in the coronary arteries.
Authors:
Masayasu Ikutomi; Takayoshi Matsumura; Hiroshi Iwata; Go Nishimura; Nobukazu Ishizaka; Yasunobu Hirata; Minoru Ono; Ryozo Nagai
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-16
Journal Detail:
Title:  Cardiology     Volume:  120     ISSN:  1421-9751     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  22-26     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
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