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Cardiac manifestations of IgG4-related disease: a case series

Ratwatte, Seshika ; Day, Martin ; Ridley, Lloyd John ; Fung, Caroline ; Naoum, Christopher ; Yiannikas, John Jensen, Christoph ; Ahmed, Rizwan ; Tsaban, Gal ; Nazmi Calik, Ali ; van Trier, Tinka Julia

European heart journal : case reports, 2022-04, Vol.6 (4), p.ytac153 [Periódico revisado por pares]

England: Oxford University Press

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  • Título:
    Cardiac manifestations of IgG4-related disease: a case series
  • Autor: Ratwatte, Seshika ; Day, Martin ; Ridley, Lloyd John ; Fung, Caroline ; Naoum, Christopher ; Yiannikas, John
  • Jensen, Christoph ; Ahmed, Rizwan ; Tsaban, Gal ; Nazmi Calik, Ali ; van Trier, Tinka Julia
  • Assuntos: Cardiac patients ; Case Series ; Coronary heart disease ; Diagnosis ; Immunoglobulin G
  • É parte de: European heart journal : case reports, 2022-04, Vol.6 (4), p.ytac153
  • Descrição: Abstract Background IgG4-related disease (IgG4-RD) is an autoimmune condition affecting almost every organ system, with an early inflammatory phase and later fibrotic consequences. Vascular manifestations, particularly, large-vessel involvement in IgG4-RD, are well described. However, important IgG4-related effects on medium-sized arteries and the pericardium are less well recognized. These less frequently reported cardiovascular effects of IgG4-RD include coronary artery stenosis, pericardial disease, cardiac masses, and valvular heart disease. Case summary This case series focuses on three patients that demonstrate the cardiovascular effects of IgG4-RD and the pitfalls and importance of early diagnosis. Cases 1 and 2 presented with cardiac manifestations prior to more typical organ systems being affected which led to a delay in diagnosis. Case 1 presented with an acute myocardial infarction secondary to IgG4-RD of the coronary arteries and Case 2 presented with pericarditis which progressed to pericardial constriction due to IgG4-RD. Case 3 already had a diagnosis of IgG4-RD from a prior renal biopsy which raised the index of suspicion that his pericardial disease and thoracic mass were also related to IgG4-RD. Discussion Cardiac manifestations of IgG4-RD remain under-recognized and include coronary artery and pericardial disease. These manifestations often precede more typical manifestations in other organ systems. Recognizing cardiac manifestations of IgG4-RD on cardiac imaging can raise clinical suspicion and act as a catalyst to ascertain a confirmatory diagnosis. Early diagnosis and treatment are crucial to prevent potentially fatal outcomes and irreversible fibrosis.
  • Editor: England: Oxford University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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