Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, China.
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, China.
BMC Cardiovasc Disord. 2023 Jul 12;23(1):347. doi: 10.1186/s12872-023-03369-7.
Coronary artery ectasia is defined as a local or diffuse dilatation of the coronary artery more than 1.5 times the diameter of the adjacent normal segment. The etiology of coronary artery ectasia is diverse, and rarely complicated with immunoglobulin G4-related disease (IgG4-related disease). A limited number of cases have been reported, with insidious onset, slow progression but poor prognosis.
we report a patient with coronary artery ectasia combined with IgG4-related disease. He has been diagnosed with IgG4-related disease 5 years after his first percutaneous coronary intervention (PCI). Despite routine treatment with steroids, he develops a large coronary aneurysm and eventually died.
It is suggested that a thorough evaluation should be performed when coronary artery ectasia is diagnosed. The factors such as manifestations of coronary artery thickening, typical imaging features, other aortas involvement, increased serum IgG4 level, etc. should be considered for early diagnosis of key etiologies.
冠状动脉扩张是指冠状动脉局部或弥漫性扩张超过相邻正常节段直径的 1.5 倍。冠状动脉扩张的病因多种多样，很少合并免疫球蛋白 G4 相关疾病（IgG4 相关疾病）。目前报道的病例数量有限，起病隐匿，进展缓慢，但预后不良。
我们报告了一例冠状动脉扩张合并 IgG4 相关疾病的患者。他在首次经皮冠状动脉介入治疗（PCI）后 5 年被诊断为 IgG4 相关疾病。尽管常规使用类固醇治疗，但他仍出现大的冠状动脉瘤，最终死亡。
建议在诊断冠状动脉扩张时应进行全面评估。应考虑冠状动脉增厚的表现、典型的影像学特征、其他主动脉受累、血清 IgG4 水平升高等因素，以便早期诊断关键病因。
