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Cardiac structural abnormalities associated with IgG4-related coronary periarteritis and inflammation revealed by

Aaron Kian-Ti Tong1, Soo-Yong Tan2, Yun-Yun Go3

  • 1Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore, Singapore.

The Canadian Journal of Cardiology
|June 22, 2014
PubMed

Insights

This case highlights how imaging, including FDG-PET/CT, can suggest IgG4-related disease (IgG4-RD) in patients with coronary aneurysms and perivascular masses, guiding diagnosis.

Area of Science:

  • Cardiology
  • Radiology
  • Immunology

Background:

  • Immunoglobulin G4-related disease (IgG4-RD) is a recently identified fibroinflammatory condition.
  • Early diagnosis and characterization of IgG4-RD are crucial for effective management.

Observation:

  • A patient presented with shortness of breath and cardiac abnormalities on chest radiograph.
  • Echocardiography revealed masses at the atrioventricular grooves.
  • CT coronary angiography and FDG-PET/CT demonstrated coronary aneurysms with hypermetabolic perivascular masses.

Findings:

  • Histological examination suggested IgG4-related disease (IgG4-RD).
  • FDG-PET/CT imaging identified characteristic patterns of inflammation and disease distribution.
  • Imaging findings correlated with suspected IgG4-RD, including involvement of coronary and iliac arteries.

Implications:

  • FDG-PET/CT can be a valuable tool in diagnosing IgG4-RD by visualizing disease extent and pattern.
  • This imaging modality may help identify optimal biopsy sites for histological confirmation.
  • Recognizing imaging features suggestive of IgG4-RD can lead to earlier diagnosis and treatment.

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