IGG4-RELATED CORONARY PERIARTERITIS: SYSTEMATIC LITERATURE REVIEW WITH OUR CASE SERIES
Authors: T. Ito et al.
In this case series the authors report four own patients with coronary periarteritis in patients with IgG4 related disease (IgG4 RD) and performed a systematic literature review.
The authors describe four patients with IgG4-related coronary periarteritis from the St. Luke’s International Hospital in Tokyo and 38 cases identified by the literature review. Coronary artery lesions were detected by a coronary CT in all but two cases. Wall thickening was the most common type of the lesion. Moreover, there were 32 (76.1%) patients with other organ involvements. The commonest other lesion was periaortitis in 21 (50.0%) patients. In cases with periaortitis, IgG and IgG4 titers were significantly higher than those without periaortitis. In addition, 15 (71.4%) patients of them had three or more IgG4 related organ involvements.
Coronary artery involvement seems to occur in IgG4 RD. The typical manifestation is coronary periarteritis with wall thickening. Coronary CT is a useful imaging modality for the diagnosis of IgG4-related coronary periarteritis. Moreover, about half of the cases coexisted with periaortitis. Unfortunately, the authors don’t mention any clinical data of these patients. The main question for me is the clinical significance of these findings. Were these patients with coronary periarteritis symptomatic? If yes, patients with IgG4 RD, especially those with large vessel involvement should be screened for coronary artery involvement.