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Coronary artery aneurysms in Wegener's granulomatosis

Jorge L Musuruana1, Javier A Cavallasca, Juan Berduc

  • 1Section of Rheumatology and Autoimmune Diseases, Hospital J.B. Iturraspe, boulevard Pellegrini 3551, CP 3000, Santa Fe, Argentina. reumatologia.iturraspe@gmail.com

Joint Bone Spine
|January 4, 2011
PubMed

Insights

Coronary artery aneurysms, rare in ANCA-associated vasculitis, can occur. This case shows successful treatment of aneurysms in microscopic polyangiitis with corticosteroids and cyclophosphamide.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Coronary artery aneurysms (CAAs) are typically linked to atherosclerosis.
  • Systemic vasculitides, including Kawasaki disease and polyarteritis nodosa (PAN), are known causes of CAAs.
  • CAAs are infrequently reported in other ANCA-associated vasculitides (AAVs).

Observation:

  • A 25-year-old male presented with an extensive anterior myocardial infarction.
  • Coronary angiography revealed the presence of coronary artery aneurysms.
  • Laboratory tests showed ANCA C positivity with elevated anti-proteinase 3 antibodies.

Findings:

  • The patient was diagnosed with ANCA-associated vasculitis presenting with coronary artery aneurysms and myocardial infarction.
  • Treatment with high-dose corticosteroids and cyclophosphamide led to the resolution of coronary artery aneurysms.

Implications:

  • This case highlights that coronary artery aneurysms can develop in microscopic polyangiitis, a small vessel vasculitis.
  • Aggressive immunosuppressive therapy can effectively manage coronary artery aneurysms in AAV.
  • Early diagnosis and treatment are crucial for preventing cardiovascular complications in vasculitis patients.

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