Improvement of Mass Lesions around Coronary Arteries and Fractional Flow Reserve after Steroid Therapy in Immunoglobulin-G4-related Coronary Periarteritis

Naoki Kubota; Kazuyuki Ozaki; Makoto Hoyano; Takeshi Okubo; Shinpei Kimura; Takao Yanagawa; Takeshi Kashimura; Takayuki Inomata

doi:10.2169/internalmedicine.7880-21

CASE REPORTS

Improvement of Mass Lesions around Coronary Arteries and Fractional Flow Reserve after Steroid Therapy in Immunoglobulin-G4-related Coronary Periarteritis

Naoki Kubota, Kazuyuki Ozaki, Makoto Hoyano, Takeshi Okubo, Shinpei Kimura, Takao Yanagawa, Takeshi Kashimura, Takayuki Inomata

Author information

Naoki Kubota
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Kazuyuki Ozaki
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Makoto Hoyano
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Takeshi Okubo
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Shinpei Kimura
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Takao Yanagawa
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Takeshi Kashimura
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
Takayuki Inomata
Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan

Keywords: Immunoglobulin-G4-related disease, coronary artery, pseudoaneurysm, steroid

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 3 Pages 351-356

DOI https://doi.org/10.2169/internalmedicine.7880-21

Details

Abstract

Immunoglobulin-G4-related disease (IgG4-RD) is a multi-organ systemic inflammatory disorder. The ideal treatment of coronary artery involvement in IgG4-RD remains uncertain due to its rarity. We herein report a case of coronary artery involvement with IgG4-RD, wherein mass lesions surrounded the coronary arteries with a moderate stenosis lesion in the right coronary artery (RCA). The fractional flow reserve (FFR) of the RCA was 0.76. After steroid therapy, the mass lesions around the coronary arteries improved. The FFR of the RCA also improved from 0.76 to 0.86. These findings suggest the efficacy of using steroid therapy for coronary artery involvement with IgG4-RD.

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