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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

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Hidden IgG4-Related Coronary Disease

Namita Ramdin1, Matthew Orde2, Siobhán B O'Neill3

  • 1Arthritis Research Canada, Richmond, Canada.

American Journal of Clinical Pathology
|March 19, 2021
PubMed

Insights

This autopsy confirmed IgG4-related coronary arteritis, a rare condition involving inflammation of the coronary arteries. Findings aid in diagnosing and preventing misdiagnosis of coronary artery vasculitis.

Area of Science:

  • Cardiovascular Pathology
  • Immunopathology
  • Radiology

Background:

  • Coronary artery vasculitis can be challenging to diagnose.
  • Immunoglobulin G4-related disease (IgG4-RD) is increasingly recognized as a systemic fibroinflammatory condition.

Purpose of the Study:

  • To present a comprehensive autopsy case with detailed radiologic and pathologic review of coronary arteries.
  • To improve diagnostic accuracy and prevent misdiagnosis of coronary artery vasculitis.

Main Methods:

  • Full autopsy performed with family consent.
  • Histologic processing of cardiac, brain, lung, and spinal cord tissues.
  • Cardiac-gated computed tomography coronary angiography.

Main Results:

  • Radiography suggested periarteritis with coronary artery ectasia and calcified atherosclerosis.
  • Histology revealed dense adventitial fibrosis, lymphoplasmacytic infiltrate, and plasma cells consistent with IgG4-related disease.
  • Marked attenuation or absence of the coronary artery media contributed to ectasia.

Conclusions:

  • Autopsy confirmed IgG4-related coronary arteritis.
  • Coronary periarteritis is an uncommon but established manifestation of IgG4-related disease.
Abstract

Keywords:
AutopsyCardiac gated computed tomography coronary angiogramCoronary arteryCoronary periarteritisIgG4-related disease

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