NEJM:IgG4相关疾病中的冠状动脉炎-病例报道

2019-05-30 xing.T 网络

推测这些异常发生在活动性疾病的早期阶段并代表损伤,而不是活跃的IgG4相关疾病。该患者开始接受低剂量阿司匹林治疗。在4个月后的随访检查中,患者仍无症状。

患者为一名47岁的男性,因评估冠状动脉扩张情况而到心内科就诊,冠状动脉扩张是他在肺结节随访中进行胸部计算机断层扫描(CT)发现的。

该患者无症状,但有活检证实IgG4相关疾病的病史,涉及胰腺和泪腺和腮腺。在目前就诊中,他没有泪腺或腮腺肿胀或腹部压痛,所有这些都是以前疾病发作的特征。他过去4年一直在接受利妥昔单抗治疗。



实验室检查结果显示正常的红细胞沉降率和血清IgG4浓度。冠状血管的心电图门控CT血管造影显示右侧冠状动脉的动脉瘤扩张,在横断面(如图A箭头所示)和冠状面(如图B箭头所示)中可见明显的动脉周围软组织增厚。左前降支冠状动脉也见弥漫性增厚和动脉瘤变化。胸主动脉、主动脉弓分支血管​​和腹主动脉未见疾病迹象。

推测这些异常发生在活动性疾病的早期阶段并代表损伤,而不是活跃的IgG4相关疾病。该患者开始接受低剂量阿司匹林治疗。在4个月后的随访检查中,患者仍无症状。 

原始出处:

Jaime de la Fuente, et al.Coronary Arteritis in IgG4-Related Disease.2019.nejm.https://www.nejm.org/doi/full/10.1056/NEJMicm1809588

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    2020-05-04 xsm927
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    2019-06-02 1ddf0692m34(暂无匿称)

    学习了,谢谢分享

    0

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    2019-05-30 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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