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Baisya R, Yerram KV, Baby A, Devarasetti PK, Rajasekhar L. Immunoglobulin G4-Related Lesions in Autoimmune Diseases: Unusual Presentations at Atypical Sites-A Tale of 2 Cases with Literature Review. Eur J Rheumatol 2023; 10:169-175. [PMID: 37873667 PMCID: PMC10765183 DOI: 10.5152/eurjrheum.2023.23052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/13/2023] [Indexed: 10/25/2023] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) coexisting with clinically apparent autoimmune diseases, such as rheumatoid arthritis (RA) or antiphospholipid syndrome (APS), is a rarely documented combination in the scientific literature. In this case-based review, we present 2 intriguing cases with preexisting autoimmune diseases, namely, RA and primary APS, who exhibited coexistent IgG4- related lesions at unusual sites. The first case pertains to a patient with known RA who presented with an encasing mass in the esophagus leading to stricture, with histopathological diagnosis of IgG4-RD.The second patient, diagnosed with primary APS, experienced breathlessness, and imaging revealed a right atrial mass. Histopathological examination of the mass confirmed IgG4-RD. Notably, both patients demonstrated significant clinical improvement upon initiation of steroid therapy. Rheumatoid arthritis patients commonly exhibit elevated levels of IgG4 in their sera; however, RA with coexisting IgG4-RD is rarely reported in the literature. Similarly, APS with IgG4-related lesions is exceedingly rare. Although there are few case reports and series on esophageal and cardiac IgG4-RD, the occurrence of such unusual location of IgG4-related lesions in the context of known autoimmunity is presented here for the first time.
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Affiliation(s)
- Ritasman Baisya
- Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Keerthi Vardhan Yerram
- Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Arun Baby
- Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Phani Kumar Devarasetti
- Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Liza Rajasekhar
- Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad, India
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2
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Yağcı AF, Asil S, Kaya C, Dinç C, Bozlar U, Barçın C. IGG4-related giant lymphoproliferative-inflammatory left atrial mass. Echocardiography 2023; 40:996-1000. [PMID: 37382184 DOI: 10.1111/echo.15645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
Cardiac masses are rare entities that can be challenging in clinical diagnosis and management. Cardiac masses can be detected incidentally in patients with an asymptomatic course or may cause systemic inflammation findings due to inflammatory cytokine release or symptoms such as shortness of breath, chest pain, syncope, sudden cardiac death, and mortality due to the location of the mass. Cardiac masses associated with systemic inflammatory disorders are uncommon in this disease group. This case report will present a case with an asymptomatic IgG4-related left atrial mass detected in routine echocardiographic control imaging due to rheumatic valve disease.
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Affiliation(s)
- Ahmet Faruk Yağcı
- Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Serkan Asil
- Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Cihad Kaya
- Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Cemal Dinç
- Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Uğur Bozlar
- Department of Radiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Cem Barçın
- Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey
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3
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Namba K, Sakai D, Mikamo H, Sugizaki Y, Sugiura Y, Hiruta N, Matsuzawa Y, Kaneko K. Serum IgG4-negative IgG4-related disease with a cardiac mass: A case report. Medicine (Baltimore) 2023; 102:e34533. [PMID: 37543826 PMCID: PMC10402970 DOI: 10.1097/md.0000000000034533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
RATIONALE Although IgG4-related disease (IgG4-RD) can affect various organs, its association with a cardiac mass is exceptionally rare. Here, we report a case of a woman with IgG4-RD and a cardiac mass and discuss 10 similar cases reported previously. PATIENT CONCERNS A 65-year-old woman was referred to our hospital for chest discomfort and back pain. DIAGNOSES In accordance with the 2019 ACR/EULAR diagnostic criteria for IgG4-RD, she was diagnosed with IgG4-RD based on dense lymphocytic infiltration on histopathology, IgG/IgG4-positive cell ratio <40%, >10/hpf IgG4-positive cells on immunostaining, and paraspinal zone soft tissue lesions in the chest. INTERVENTIONS An external pacemaker was implanted for the complete atrioventricular block on the electrocardiogram. After the diagnosis of IgG4-RD, she was treated with glucocorticoids and rituximab. OUTCOMES She remains under observation without disease recurrence. LESSONS IgG4-RD are usually treated with glucocorticoids; however, in cases of a cardiac mass, life-threatening complications may occur and surgery is often needed. Combination therapy with glucocorticoids and rituximab may be effective even in patients with IgG4-RD and cardiac mass, which may avoid the need of invasive treatments, such as surgery.
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Affiliation(s)
- Kensuke Namba
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Daiki Sakai
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Hiroshi Mikamo
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Yuta Sugizaki
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Yoshiya Sugiura
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Yasuo Matsuzawa
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Kaichi Kaneko
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
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Elevated Serum Levels of IgG4 in Patients with Heart Failure with Reduced Ejection Fraction: A Prospective Controlled Study. BIOLOGY 2022; 11:biology11081168. [PMID: 36009795 PMCID: PMC9404706 DOI: 10.3390/biology11081168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
(1) Background: Immunoglobulin gamma subclass 4 (IgG4) is a serum protein belonging to the immunoglobulin superfamily. It has a central role in certain immune-mediated conditions defined as IgG4-related disease. There is a paucity of data regarding the potential association of IgG4 and cardiovascular diseases. Our aim is to study the serum levels of IgG4 in patients with ischemic and non-ischemic dilated cardiomyopathy (DCM). (2) Methods: patients with ischemic and non-ischemic DCM were included in this study. Non-ischemic DCM was defined as a left ventricular ejection fraction (LVEF) < 40% without coronary artery disease (CAD). Ischemic DCM was defined as a LVEF < 40% and proven CAD. The serum concentrations of IgG4 were measured by turbidimetry. (3) Results: Overall 98 patients with cardiomyopathy had significantly higher levels of IgG4 compared with the control group (77.4 ± 64.0 vs. 50.3 ± 28.8 mg/dL, p < 0.01). Although there was no difference in the total IgG levels in patients with ischemic DCM, the serum concentrations of IgG4 were significantly higher than the corresponding values in the control group (89.8 ± 67.3 vs. 50.3 ± 28.8 mg/dL; interquartile ranges: 40.4−126.5 vs. 31.8−66.8 mg/dL, p < 0.01). This was altered by gender and smoking. (4) Conclusions: The patients with ischemic DCM had increased serum concentrations of IgG4. Future studies are warranted to explore the potential role of an IgG4-mediated process in patients with heart failure with reduced LVEF.
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5
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Nomura S, Ishii W, Hara R, Nanasawa S, Nishiwaki K, Kagoshima M, Takano T, Satomi H, Usui T. IgG4-related Disease with a Cardiac Mass Causing Cerebral Infarction. Intern Med 2022; 61:1259-1264. [PMID: 34615822 PMCID: PMC9107975 DOI: 10.2169/internalmedicine.8049-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease characterized by infiltration of extensive IgG4-positive plasma cells and lymphocytes. Although IgG4-RD has been observed in almost all organs, it rarely affects the myocardium. Cardiovascular lesions of IgG4-RD appear as aortic (aortic aneurysm and aortitis) and pericardial (constrictive pericarditis) lesions as well as pseudotumors around the coronary arteries. We herein report a case of IgG4-RD with a cardiac mass in the right atrium involving a sinus node. This condition caused arrhythmia and repeated strokes. We successfully treated the patient through resection of the cardiac mass, catheter ablation and immunosuppressive therapy.
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Affiliation(s)
- Shun Nomura
- Division of Rheumatology, Department of Internal Medicine, Nagano Red Cross Hospital, Japan
| | - Wataru Ishii
- Division of Rheumatology, Department of Internal Medicine, Nagano Red Cross Hospital, Japan
| | - Ryosuke Hara
- Division of Rheumatology, Department of Internal Medicine, Nagano Red Cross Hospital, Japan
| | | | - Kei Nishiwaki
- Division of Cardiology, Joetsu General Hospital, Japan
| | | | - Tamaki Takano
- Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Japan
| | | | - Tatsuya Usui
- Department of Cardiology, Nagano Red Cross Hospital, Japan
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6
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Kondo N, Kasamatsu H, Nakazawa H, Tanaka H, Kuroiwa KK, Ide S. Is That a Real Tumor? J Cardiothorac Vasc Anesth 2021; 35:2530-2532. [PMID: 33875354 DOI: 10.1053/j.jvca.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Nami Kondo
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan.
| | - Haruka Kasamatsu
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan
| | - Haruka Nakazawa
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan
| | - Hidenori Tanaka
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan
| | - Kaori Kimura Kuroiwa
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan
| | - Susumu Ide
- Department of Anesthesiology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, Japan
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7
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Hajsadeghi S, Pakbaz M, Hassanzadeh M, Sadeghipour A. A challenging case report of IgG4-related systemic disease involving the heart and retroperitoneum with a literature review of similar heart lesions. Echocardiography 2020; 37:1478-1484. [PMID: 32841427 DOI: 10.1111/echo.14828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
The IgG4-related disease is a distinct, steroid-responsive fibro-inflammatory disorder of unknown etiology. This multiorgan disease is characterized by tumefactive lesions that contain rich infiltrations of IgG4-positive plasma cells, with the pancreas, and the salivary and lacrimal glands being the main involved. The more common cardiovascular involvements include inflammatory peri-aortitis, coronary arteritis, and pericarditis. Intra-cardiac tumefactive lesions are rarely reported. Herein, we describe a challenging case of IgG4-related disease with a long-time lag between initiation of symptoms to proper diagnosis with biopsy-proven cardiac and retroperitoneal and possible pituitary gland involvement. Concerning the rarity of the cardiac lesion in our case, we conducted a literature review of similar case reports.
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Affiliation(s)
- Shokoufeh Hajsadeghi
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Marziyeh Pakbaz
- Department of Cardiovascular Disease, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Hassanzadeh
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Sadeghipour
- Department of Pathology and Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
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8
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Matsumura I, Mitsui T, Tahara K, Shimizu H, Yanagisawa K, Ishizaki T, Koiso H, Takizawa M, Yokohama A, Saitoh T, Hirato J, Murakami H, Handa H, Tsukamoto N. IgG4-related Disease with a Cardiac Mass. Intern Med 2020; 59:1203-1209. [PMID: 31956206 PMCID: PMC7270767 DOI: 10.2169/internalmedicine.4054-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A 69-year-old man with palpitations and decreased blood pressure was referred. Echocardiography showed a mass in the right atrium and cardiac septum. The serum IgG4 level was 1,450 mg/dL. A biopsy of the cardiac mass showed fibrosis with inflammatory cells and increased IgG4-positive plasma cells and lymphocytes. Flow cytometry and polymerase chain reaction of the immunoglobulin heavy chain did not demonstrate monoclonality. He was diagnosed with IgG4-related disease (IgG4-RD). IgG4-RD with a cardiac mass is rare and it is difficult to distinguish it from malignant lymphoma by a pathological examination alone. We therefore performed a biopsy and analyzed the clonality in order to make an accurate diagnosis of IgG4-RD.
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Affiliation(s)
- Ikuko Matsumura
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Takeki Mitsui
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Kenichi Tahara
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Hiroaki Shimizu
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Kunio Yanagisawa
- Infection Control and Prevention Center, Gunma University Hospital, Japan
| | - Takuma Ishizaki
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Hiromi Koiso
- Infection Control and Prevention Center, Gunma University Hospital, Japan
| | - Makiko Takizawa
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Akihiko Yokohama
- Division of Blood Transfusion Service, Gunma University Hospital, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Science, Japan
| | - Junko Hirato
- Department of Pathology, Gunma University Hospital, Japan
| | - Hirokazu Murakami
- Department of Laboratory Sciences, Gunma University Graduate School of Health Science, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Japan
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9
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Maeda R, Naito D, Adachi A, Shiraishi H, Sakamoto T, Matoba S. IgG4-related Disease Involving the Cardiovascular System: An Intracardiac Mass and a Mass Lesion Surrounding a Coronary Artery. Intern Med 2019; 58:2363-2366. [PMID: 31118383 PMCID: PMC6746635 DOI: 10.2169/internalmedicine.2509-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis developed a mass in the right atrium (RA) and a mass lesion surrounding the left anterior descending coronary artery. We performed an intracardiac echo catheter-guided percutaneous biopsy of the RA mass, and histologically diagnosed it as IgG4-related disease. Oral corticosteroid therapy gradually downsized the mass lesions. We encountered a very rare case with mass lesions in the cardiovascular system of the IgG4-related disease that were able to be diagnosed using an intracardiac echo-guided biopsy.
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Affiliation(s)
- Ryotaro Maeda
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
| | - Daisuke Naito
- Department of Cardiology, Fukuchiyama City Hospital, Japan
| | - Atsuo Adachi
- Department of Cardiology, Fukuchiyama City Hospital, Japan
| | - Hirokazu Shiraishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
| | | | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
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10
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Blazekovic R, Planinc M, Catic J, Baric D, Unic D, Manojlovic L, Holzer S. Immunoglobulin G4 Inflammatory Aortic Aneurysm Mimicking Acute Aortic Syndrome. Ann Thorac Surg 2019; 108:e179-e181. [PMID: 30771330 DOI: 10.1016/j.athoracsur.2019.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
Abstract
Immunoglobulin-G4-related disease (IgG4RD) is a novel clinical entity characterized by lymphoplasmacytic infiltrates presenting as an excessive fibrosis such as retroperitoneal inflammatory pseudotumor but rarely affecting the heart or the aorta. We describe a case of IgG4RD with multifocal aortic involvement presenting as an acute aortic syndrome.
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Affiliation(s)
- Robert Blazekovic
- Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia; Faculty of Medicine, "J.J. Strossmayer" University of Osijek, Osijek, Croatia
| | - Mislav Planinc
- Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia.
| | - Jasmina Catic
- Faculty of Medicine, "J.J. Strossmayer" University of Osijek, Osijek, Croatia; Department of Cardiology, Dubrava University Hospital, Zagreb, Croatia
| | - Davor Baric
- Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia
| | - Daniel Unic
- Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia
| | - Luka Manojlovic
- Department of Clinical and Experimental Pathology, Dubrava University Hospital, Zagreb, Croatia
| | - Sabrina Holzer
- Department of Orthopedics and Trauma Surgery, General Hospital of Vienna, Austria
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12
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Yano T, Yamamoto M, Mochizuki A, Ogawa T, Nagano N, Fujito T, Nishida J, Nagahara D, Abe K, Miki T, Suzuki C, Takahashi H, Ishibashi-Ueda H, Miura T. Successful Transcatheter Diagnosis and Medical Treatment of Right Atrial Involvement in IgG4-related Disease. Int Heart J 2018; 59:1155-1160. [DOI: 10.1536/ihj.17-467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Motohisa Yamamoto
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University
| | - Atsushi Mochizuki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Toshifumi Ogawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Junichi Nishida
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Daigo Nagahara
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University
| | - Koki Abe
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Chisako Suzuki
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University
| | | | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
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13
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Infrequent organ involvement of IgG4-related diseases: a literature review. Clin Rheumatol 2018; 37:1153-1159. [PMID: 29502226 DOI: 10.1007/s10067-018-4048-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/30/2018] [Accepted: 02/19/2018] [Indexed: 01/28/2023]
Abstract
IgG4-related disease (IgG4-RD) is a chronic and systemic disease that can involve multiple organs. The most commonly involved organs include the salivary glands, orbital adnexal structures, paranasal sinus, thyroid, lungs, breasts, aorta, pancreas, biliary ducts, kidneys, retroperitoneum, lymph nodes, prostate, pituitary, and endocranium. Due to increased disease research, several new site-specific nuances of IgG4-RD have been described. The authors have reviewed the recent literature and briefly summarize the infrequent organ involvement of IgG4-RD.
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14
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Tiong BK, Fishbein GA, Brahn E. IgG4-related disease of the mitral valve demonstrated by immunohistochemistry. Ann Rheum Dis 2018; 77:1384-1385. [DOI: 10.1136/annrheumdis-2018-213042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 11/04/2022]
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15
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Besik J, Pirk J, Netuka I, Szarszoi O, Marek T, Urban M, Honsova E, Laco J. Aortic and Mitral Valve Replacement Due to Extensive Inflammatory Immunoglobulin G4–Related Pseudotumor. Ann Thorac Surg 2015; 100:1439-41. [DOI: 10.1016/j.athoracsur.2014.12.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/01/2014] [Accepted: 12/05/2014] [Indexed: 01/06/2023]
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16
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A Case of Immunoglobulin G4-Related Disease with Extensive Multiorgan Involvements. Case Rep Rheumatol 2015; 2015:392893. [PMID: 26101684 PMCID: PMC4460202 DOI: 10.1155/2015/392893] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 05/18/2015] [Indexed: 12/24/2022] Open
Abstract
We report a case of IgG4-related disease (IgG4-RD) with multiple ten-organ involvement. This case showed many clinical findings, such as bilateral swelling of salivary and lacrimal glands, autoimmune pancreatitis, interstitial nephritis, retroperitoneal fibrosis, periaortitis, systemic swelling of lymph nodes, pulmonary lesions, splenomegaly, and jejunal lesions. He was suspected as having SLE or malignant lymphoma but diagnosed as having IgG4-RD by the elevated serum IgG4 level and histological findings from kidney and lymph node. We report a case of IgG4-RD with multiple ten-organ involvement that was successfully treated with prednisolone therapy.
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18
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Maleszewski JJ, Tazelaar HD, Horcher HM, Hinkamp TJ, Conte JV, Porterfield JK, Halushka MK. IgG4-related disease of the aortic valve: a report of two cases and review of the literature. Cardiovasc Pathol 2015; 24:56-9. [DOI: 10.1016/j.carpath.2014.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 07/22/2014] [Accepted: 08/02/2014] [Indexed: 12/24/2022] Open
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