Abstract
Immunoglobulin G4-related disease (IgG4-RD) is an insidiously progressive multiorgan
disease. However, lack of familiarity with IgG4-RD results in patients often being
undiagnosed and undertreated. IgG4-RD can affect any organ, and manifests as aortitis
within the cardiovascular system. Cardiac involvement is less common, and myocardial
infarction is rarely reported. We report the first case of a patient with multiple
myocardial infarctions caused by recurrent stent thrombosis associated with IgG4-RD,
which resolved upon treatment of IgG4-RD. This case highlights the importance for
cardiologists to consider IgG4-RD as a rare but possible association with stent thrombosis.
Résumé
La maladie associée aux immunoglobulines G4 (IgG4-RD) est une pathologie multiviscérale
qui évolue de façon insidieuse. Cependant, la méconnaissance de celle-ci fait en sorte
qu'elle échappe au diagnostic et se trouve sous-traitée dans bien des cas. L'IgG4-RD
peut toucher n'importe quel organe. Dans le cas de l'appareil cardiovasculaire, elle
se manifeste par une aortite. L'atteinte cardiaque est moins fréquente et l'infarctus
du myocarde, rarement signalé. Nous présentons le premier cas d'infarctus du myocarde
à répétition causés par une thrombose récurrente de l'endoprothèse associée à l'IgG4-RD,
qui ne s'est plus reproduite une fois l'IgG4-RD traitée. Ce cas souligne qu'il est
important que les cardiologues envisagent l'association rare, mais possible de l'IgG4-RD
à la thrombose de l'endoprothèse.
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References
- The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease.Ann Rheum Dis. 2020; 79: 77-87
- Coronary artery disease concomitant with immunoglobulin G4-related disease: a case report and literature review.Eur Heart J Case Rep. 2019; 3 (ytz013)
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- Distinctive pulmonary histopathology with increased IgG4-positive plasma cells in patients with autoimmune pancreatitis: report of 6 and 12 cases with similar histopathology.Am J Surg Pathol. 2009; 33: 1450-1462
Article info
Publication history
Published online: June 03, 2021
Accepted:
May 28,
2021
Received:
April 27,
2021
Footnotes
See page 1660 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
