A case of IgG4-related lymphadenopathy, pericarditis, coronary artery periarteritis and luminal stenosis

Heart Vessels. 2016 Oct;31(10):1709-13. doi: 10.1007/s00380-016-0794-1. Epub 2016 Jan 21.

Abstract

Immunoglobulin G4 (IgG4)-related disease is an emerging new clinicopathological disorder that is characterized by elevation of serum IgG4 levels and histological findings of IgG4-positive plasmacytic infiltration. IgG4-related disease may appear synchronously or metachronously in a wide variety of organs. The current patient was found to have pericardial effusion and retroperitoneal fibrosis. He was subsequently diagnosed with coronary artery stenosis. (18)F-FDG positron emission tomography showed enhanced FDG uptake in lymph nodes as well as pericardial and peri-aortic tissue. Histopathology of the mediastinal lymph node showed the infiltration of numerous IgG4-positive cells, leading to the diagnosis of IgG4-related lymphadenopathy with pericardial and periarterial involvement.

Keywords: Cardiovascular system; IgG4-related disease; Lymphadenopathy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Aged
  • Aorta, Abdominal / diagnostic imaging*
  • Constriction, Pathologic / diagnostic imaging
  • Coronary Vessels / diagnostic imaging
  • Drainage / methods
  • Humans
  • Immunoglobulin G / blood*
  • Lymphadenopathy / diagnostic imaging*
  • Lymphadenopathy / drug therapy
  • Lymphadenopathy / pathology
  • Male
  • Pericarditis / diagnostic imaging*
  • Pericarditis / drug therapy
  • Pericardium / pathology
  • Pleural Effusion / therapy*
  • Positron Emission Tomography Computed Tomography

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin G