Sakamoto Aiko, Tanaka Tomofumi, Hirano Kenji, Koike Kazuhiko, Komuro Issei
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Japan.
Division for Health Service Promotion, University of Tokyo, Japan.
Intern Med. 2017 Sep 15;56(18):2445-2450. doi: 10.2169/internalmedicine.8259-16. Epub 2017 Aug 21.
Immunoglobulin G4 (IgG4)-related disease is a systemic inflammatory disorder that was first described in patients with autoimmune pancreatitis. Although IgG4-related disease is thought to involve the cardiovascular system, case reports describing coronary artery involvement are relatively rare. We describe a patient who was previously diagnosed with autoimmune pancreatitis and found to have coronary periarteritis and luminal narrowing. After the initiation of steroid treatment, the patient's coronary periarteritis and luminal stenosis were both ameliorated with an improvement in the serum IgG4 concentration. The present findings collectively suggest that IgG4-related immuno-inflammation may have a role in the development of coronary periarteritis and luminal atherosclerosis.
免疫球蛋白G4(IgG4)相关疾病是一种全身性炎症性疾病,最初在自身免疫性胰腺炎患者中被描述。尽管IgG4相关疾病被认为累及心血管系统,但描述冠状动脉受累的病例报告相对较少。我们描述了一名先前被诊断为自身免疫性胰腺炎的患者,发现其患有冠状动脉周围炎和管腔狭窄。在开始使用类固醇治疗后,患者的冠状动脉周围炎和管腔狭窄均得到改善,血清IgG4浓度也有所下降。目前的研究结果共同表明,IgG4相关的免疫炎症可能在冠状动脉周围炎和管腔动脉粥样硬化的发生中起作用。