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与IgG4相关的疾病表现为扩散冠状动脉样硬化,其特征是显著的脂质丰富的瘤核心负担

Francisco X Elisarraras¹, Robert A Pelberg², Jacob S Roberts³

¹University of California-Los Angeles Health, Los Angeles, California, USA.

JACC. Case reports

|March 6, 2026

概括

与免疫球蛋白G4相关的疾病 (IgG4-RD) 可以导致无声的,高风险的冠状动脉样硬化. 警和主动成像对于管理这种罕见的心血管症状至关重要.

科学领域:

心血管医学心血管医学
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) 是一种全身性纤维炎症疾病,涉及多种器官.
心血管疾病的表现,如主动脉炎和周动脉炎是公认的,但冠状动脉的参与是罕见的和不太了解.
现有的文献经常将冠状动脉IgG4-RD与炎症,脱血或动脉瘤联系起来,而不是典型的高风险动脉样硬化.

研究的目的:

描述一种与IgG4相关的冠状动脉干扰病例,呈现为严重动脉样硬化.
突出IGG4-RD患者临床上沉默的高风险冠状动脉疾病的潜力.

主要方法:

一名63岁的男性患有已知的IgG4-RD和血清IgG4升高,接受了计算机断层扫描和冠状动脉计算机断层扫描血管造影.
进行了先进的斑块分析,以评估冠状动脉样硬化.
患者出现了腹部疼痛,但没有心脏症状.

主要成果:

计算机断层扫描揭示了大心周炎症和偶尔的冠状动脉化.
冠状动脉扫描显示了无动脉瘤变化而无扩散的冠状动脉结.
斑块分析表明,脂质丰富的死核和非化斑块的负担很高,这意味着高风险的动脉样硬化.

结论:

这一案例扩大了对IgG4相关冠状动脉疾病谱的理解.
它表现出严重的,与炎症相关的动脉样硬化,没有脱血或动脉瘤.
IgG4-RD患者可能有沉默的,高风险的冠状动脉疾病,需要主动成像和管理.

关键词:

与IgG4相关的疾病 (IgG4-RD)动脉样硬化动脉样硬化心脏风险心脏风险冠状动脉CT血管造影 (CCTA)冠状动脉疾病 (CAD) 是一种冠状动脉疾病.冠状动脉周动脉炎的冠状动脉周动脉炎.高风险斑块 - 高风险斑块脂质丰富的死核 (LRNC) 是一种斑块的表征斑块的表征首要预防首要预防风险因素的风险因素是什么二次预防二次预防.

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