A Case of Aortic Stenosis with Serum IgG4 Elevation, and IgG4-Positive Plasmacytic Infiltration in the Aortic Valve, Epicardium, and Aortic Adventitia
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- Hourai Ryoto
- Department of Cardiology, Osaka Medical College
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- Kasashima Satomi
- Department of Clinical Laboratory Science, Kanazawa University
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- Fujita Shu-ichi
- Department of Cardiology, Osaka Medical College
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- Sohmiya Koichi
- Department of Cardiology, Osaka Medical College
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- Daimon Masahiro
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
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- Hirose Yoshinobu
- Department of Pathology, Osaka Medical College
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- Katsumata Takahiro
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
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- Kanki Sachiko
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
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- Ozeki Michishige
- Department of Cardiology, Osaka Medical College
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- Ishizaka Nobukazu
- Department of Cardiology, Osaka Medical College
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Abstract
<p>A 74-year-old man was admitted for preoperative screening of aortic stenosis. Five months before this admission, he was found to have elevated serum immunoglobulin G4 (IgG4; 2,010 mg/dL). Computed tomography (CT) showed a soft tissue mass surrounding the abdominal aorta, suggestive of IgG4-related periaortitis. CT coronary angiography showed perivascular thickening of the right coronary artery, and subsequent coronary angiography showed a multi-vessel disease. The patient underwent aortic valve replacement and coronary bypass surgery. Immunohistochemical analysis showed IgG4-positive plasmacytic infiltration in specimens from the aortic valve, epicardium, and aortic adventitia, suggestive of the possible role of IgG4-related immune inflammation for the pathogenesis.</p>
Journal
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- International Heart Journal
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International Heart Journal 59 (5), 1149-1154, 2018-09-01
International Heart Journal Association