Immunoglobulin G4-Related Multiple Giant Coronary Artery Aneurysms and a Single Left Gastric Artery Aneurysm

Area of Science:

• Cardiovascular Medicine
• Immunology
• Gastroenterology

Background:

• Coronary artery aneurysms (CAAs) pose significant life-threatening risks.
• Immunoglobulin G4-related disease (IgG4-RD) is an emerging condition with diverse systemic manifestations.
• Vascular involvement, including aneurysms, is increasingly recognized in IgG4-RD.

Observation:

• A unique case involving multiple giant coronary artery aneurysms (gCAAs) and a single left gastric artery aneurysm is presented.
• The patient's condition was diagnosed as being caused by immunoglobulin G4-related disease (IgG4-RD).
• This presentation underscores the potential for IgG4-RD to affect multiple large arteries, including coronary and gastric arteries.

Findings:

• Immunoglobulin G4-related disease (IgG4-RD) can manifest as multiple giant coronary artery aneurysms (gCAAs) and aneurysms in other major arteries, such as the left gastric artery.
• The findings support a causal link between IgG4-RD and the development of these extensive arterial aneurysms.
• Histopathological examination (if available) would further confirm IgG4-related inflammation in the affected vessels.

Implications:

• Diagnosing immunoglobulin G4-related disease (IgG4-RD) is crucial for patients presenting with coronary artery aneurysms (CAAs), especially those with multiple or giant aneurysms.
• Screening for concurrent cardiovascular involvements, including aneurysms in other arterial territories, is recommended in patients with IgG4-RD.
• Early recognition and management of IgG4-RD can potentially prevent further vascular complications and improve patient outcomes.