Coronary artery involvement in a patient with IgG4-related disease
Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive plasma cells toward several organs. Coronary artery involvement is rarely seen in IgG4-RD patients; thereby, we aim to outline the nonin...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-10-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043323005009 |
| _version_ | 1797737983540985856 |
|---|---|
| author | Ali Mohammadzadeh, MD Golnaz Houshmand, MD Hamidreza Pouraliakbar, MD Zeinab Soltani, MD Ghazaleh Salehabadi, MD, MPH Amir Azimi, MD Reza Shabanian, MD |
| author_facet | Ali Mohammadzadeh, MD Golnaz Houshmand, MD Hamidreza Pouraliakbar, MD Zeinab Soltani, MD Ghazaleh Salehabadi, MD, MPH Amir Azimi, MD Reza Shabanian, MD |
| author_sort | Ali Mohammadzadeh, MD |
| collection | DOAJ |
| description | Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive plasma cells toward several organs. Coronary artery involvement is rarely seen in IgG4-RD patients; thereby, we aim to outline the noninvasive imaging findings of this rare case. Cardiac magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) from a 15-year-old female diagnosed with IgG4-RD via histopathological assessment of orbital biopsy, were analyzed. CMR showed a severely reduced left ventricular ejection fraction and akinesia of the basal to mid-lateral, anterior, and septal walls. Inflammation of the basal to apical lateral wall and subendocardial infarction of the basal to apical lateral and mid inferoseptal walls were also evident. CCTA findings showed stenosis in branches of the left main artery (LM), left anterior descending artery (LAD), and right coronary artery (RCA), aortitis, and aortic wall thickening. After courses of proper treatment with prednisolone, Cellcept, and adalimumab, follow-up CMR showed significant improvement in LV systolic function and resolution of inflammation. Although IgG4-RD is an uncommon cause of coronary artery disease, it can cause lethal complications such as myocardial infarction. Hence, clinicians should be aware of cardiac complications in these patients. |
| first_indexed | 2024-03-12T13:36:22Z |
| format | Article |
| id | doaj.art-6720cbfd89994e88bb7a8bca5f6455f2 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-03-12T13:36:22Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-6720cbfd89994e88bb7a8bca5f6455f22023-08-24T04:34:39ZengElsevierRadiology Case Reports1930-04332023-10-01181036993703Coronary artery involvement in a patient with IgG4-related diseaseAli Mohammadzadeh, MD0Golnaz Houshmand, MD1Hamidreza Pouraliakbar, MD2Zeinab Soltani, MD3Ghazaleh Salehabadi, MD, MPH4Amir Azimi, MD5Reza Shabanian, MD6Rajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, IranRajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, IranRajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, IranRajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, IranRajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, IranRajaie Cardiovascular Medical and Research Center, Iran University of medical sciences, Tehran, Iran; Corresponding author.Children`s Medical Center, Tehran University of Medical Sciences, Tehran, IranImmunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive plasma cells toward several organs. Coronary artery involvement is rarely seen in IgG4-RD patients; thereby, we aim to outline the noninvasive imaging findings of this rare case. Cardiac magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) from a 15-year-old female diagnosed with IgG4-RD via histopathological assessment of orbital biopsy, were analyzed. CMR showed a severely reduced left ventricular ejection fraction and akinesia of the basal to mid-lateral, anterior, and septal walls. Inflammation of the basal to apical lateral wall and subendocardial infarction of the basal to apical lateral and mid inferoseptal walls were also evident. CCTA findings showed stenosis in branches of the left main artery (LM), left anterior descending artery (LAD), and right coronary artery (RCA), aortitis, and aortic wall thickening. After courses of proper treatment with prednisolone, Cellcept, and adalimumab, follow-up CMR showed significant improvement in LV systolic function and resolution of inflammation. Although IgG4-RD is an uncommon cause of coronary artery disease, it can cause lethal complications such as myocardial infarction. Hence, clinicians should be aware of cardiac complications in these patients.http://www.sciencedirect.com/science/article/pii/S1930043323005009Case reportIgG4-RDCoronary arteryIschemic cardiomyopathyComputed tomography angiographyCardiac magnetic resonance imaging |
| spellingShingle | Ali Mohammadzadeh, MD Golnaz Houshmand, MD Hamidreza Pouraliakbar, MD Zeinab Soltani, MD Ghazaleh Salehabadi, MD, MPH Amir Azimi, MD Reza Shabanian, MD Coronary artery involvement in a patient with IgG4-related disease Radiology Case Reports Case report IgG4-RD Coronary artery Ischemic cardiomyopathy Computed tomography angiography Cardiac magnetic resonance imaging |
| title | Coronary artery involvement in a patient with IgG4-related disease |
| title_full | Coronary artery involvement in a patient with IgG4-related disease |
| title_fullStr | Coronary artery involvement in a patient with IgG4-related disease |
| title_full_unstemmed | Coronary artery involvement in a patient with IgG4-related disease |
| title_short | Coronary artery involvement in a patient with IgG4-related disease |
| title_sort | coronary artery involvement in a patient with igg4 related disease |
| topic | Case report IgG4-RD Coronary artery Ischemic cardiomyopathy Computed tomography angiography Cardiac magnetic resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S1930043323005009 |
| work_keys_str_mv | AT alimohammadzadehmd coronaryarteryinvolvementinapatientwithigg4relateddisease AT golnazhoushmandmd coronaryarteryinvolvementinapatientwithigg4relateddisease AT hamidrezapouraliakbarmd coronaryarteryinvolvementinapatientwithigg4relateddisease AT zeinabsoltanimd coronaryarteryinvolvementinapatientwithigg4relateddisease AT ghazalehsalehabadimdmph coronaryarteryinvolvementinapatientwithigg4relateddisease AT amirazimimd coronaryarteryinvolvementinapatientwithigg4relateddisease AT rezashabanianmd coronaryarteryinvolvementinapatientwithigg4relateddisease |