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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
Summary
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.
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