在IgG4-RD中冠状动脉周周炎:一个病例系列
Georges El Hasbani1, Daniel Larson2, Matthew J Koster3
1Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55906, USA. ElHasbani.georges@mayo.edu.
Clinical rheumatology
|September 10, 2025
概括
与IgG4相关的疾病 (IgG4-RD) 很少会影响冠状动脉,导致周动脉炎和潜在的心脏并发症. 用葡萄糖皮质激素和修复剂治疗在这个病例系列中显示出有效性.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫球蛋白G4相关疾病 (IgG4-RD) 是一种多系统性纤维炎症疾病.
- 冠状动脉参与IgG4-RD,呈现为周动脉炎,是不常见的.
- 冠状动脉周周炎可能导致严重的心脏并发症,包括心肌梗塞和缺血性心肌病.
研究的目的:
- 描述IgG4-RD相关冠状动脉周关节炎的临床和放射性特征.
- 为了确定与这种罕见疾病相关的并发症.
- 评估受影响患者的治疗策略和结果.
主要方法:
- 梅奥诊所电子健康记录的回顾性审查.
- 纳入标准:IgG4-RD的诊断与确认的冠状动脉周动脉炎.
- 对9名患者的临床,实验室,成像,治疗和结局数据的分析.
主要成果:
- 该队列包括9名男性患者,平均年龄为55.5岁.
- 血清IgG-4水平的中位数为282 mg/dL;中位数的C-反应蛋白是10.8 mg/dL.
- 在大多数情况下,CT血管图显示冠状动脉壁变厚,有两例动脉瘤形成. 葡萄糖皮质类药物和修复剂被管理. 在长达7.5年的随访期间,一名患者患上了缺血性心脏病,另一个患上了心力衰竭. 七名患者显示,冠状动脉结厚的症状已经消失.
结论:
- IgG4-RD冠状动脉周周炎很少见,但可能导致动脉瘤和缺血并发症.
- CT和MRI对诊断非常有价值.
- 结合葡萄糖皮质激素和利图西马布治疗似乎是有效的,需要进一步调查长期结果.
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