Serial Imaging Follow-Up for Immunoglobulin G4-Related Coronary Arteritis With Acute Coronary Syndrome

A 49-year-old Japanese man received a diagnosis of immunoglobulin G4–related coronary arteritis (IgG4-RCA), discovered following the detection of abdominal aorta wall thickening on computed tomography (CT). Intravascular ultrasonography (IVUS) revealed thickening of both the adventitia and the intim...

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Veröffentlicht in:JACC. Case reports 2024-10, Vol.29 (19), p.102561, Article 102561
Hauptverfasser: Hata, Satoshi, Ota, Shingo, Ino, Yasushi, Miyamoto, Masaoki, Okumoto, Yasushi, Kimura, Keizo, Tanaka, Atsushi
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container_issue 19
container_start_page 102561
container_title JACC. Case reports
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creator Hata, Satoshi
Ota, Shingo
Ino, Yasushi
Miyamoto, Masaoki
Okumoto, Yasushi
Kimura, Keizo
Tanaka, Atsushi
description A 49-year-old Japanese man received a diagnosis of immunoglobulin G4–related coronary arteritis (IgG4-RCA), discovered following the detection of abdominal aorta wall thickening on computed tomography (CT). Intravascular ultrasonography (IVUS) revealed thickening of both the adventitia and the intima-media complex (IMC) in the left anterior descending (LAD) coronary artery, without significant stenosis. Corticosterone therapy was administered. On the fifth day of corticosterone therapy, the patient experienced an acute coronary syndrome secondary to LAD artery ostium occlusion, and a primary percutaneous coronary intervention was performed. After 3 months of corticosterone therapy, IVUS follow-up showed a decrease in the adventitia and IMC thickening. After 9 months of corticosterone therapy, positron emission tomography combined with CT revealed that the abnormal accumulation of fluorodeoxyglucose in the coronary arteries and abdominal aorta had disappeared. Considering the treatment process and the existing literature, there is a possibility that the adventitia and IMC deformation was induced by IgG4-RCA. [Display omitted]
doi_str_mv 10.1016/j.jaccas.2024.102561
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subjects Imaging
immunoglobulin G4–related disease
intravascular ultrasonography
positron emission tomography–computed tomography
ST-segment elevated myocardial infarction
title Serial Imaging Follow-Up for Immunoglobulin G4-Related Coronary Arteritis With Acute Coronary Syndrome
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