A Case of Suspected Immunoglobulin G4-related Pericoronary Inflammation Treated by Coronary Artery Bypass Grafting

Abstract

A 66-year-old man had two coronary arterial lesions. Contrast-enhanced CT revealed inflammatory thickenings around the coronary arteries, the superior mesenteric artery, and the abdominal aorta. Blood testing showed a high serum IgG4 level. Therefore, pericoronary inflammation due to IgG4-related diseases was strongly suspected. Because percutaneous intracoronary stenting might cause coronary aneurysm formation, coronary artery bypass grafting was performed. However, it was difficult to detect IgG4-positive cells of coronary artery wall by histopathological examination. We report the relatively rare IgG4-related pericoronary inflammation treated by coronary artery bypass grafting.