Immunoglobulin G4-related multiple cardiovascular lesions successfully treated with a combination of open surgery and corticosteroid therapy

J Vasc Surg. 2015 Jun;61(6):1599-603. doi: 10.1016/j.jvs.2013.10.106. Epub 2013 Dec 17.

Abstract

Immunoglobulin G4-related disease, a newly emerging systemic autoimmune disorder, can potentially involve the cardiovascular system. The standard treatment for immunoglobulin G4-related cardiovascular disease has not been established. We encountered a very rare case of an immunoglobulin G4-related inflammatory abdominal aortic aneurysm coexisting with a coronary artery aneurysm and periarteritis. The patient underwent surgical resection for the abdominal aortic aneurysm, followed by successful corticosteroid therapy for the coronary artery lesions. This is the first report of steroid-sensitive immunoglobulin G4-related coronary artery disease. A carefully planned treatment strategy for the multiple cardiovascular lesions was invaluable in the present case.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Aged
  • Aortic Aneurysm, Abdominal / blood
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / immunology
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Arteritis / diagnosis
  • Arteritis / drug therapy
  • Arteritis / immunology
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / drug therapy*
  • Autoimmune Diseases / immunology
  • Biomarkers / blood
  • Biopsy
  • Blood Vessel Prosthesis Implantation*
  • Combined Modality Therapy
  • Coronary Aneurysm / blood
  • Coronary Aneurysm / diagnosis
  • Coronary Aneurysm / drug therapy*
  • Coronary Aneurysm / immunology
  • Humans
  • Immunoglobulin G / blood*
  • Immunohistochemistry
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Biomarkers
  • Immunoglobulin G
  • Immunosuppressive Agents