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Clinicopathological features of immunoglobulin G4-related constrictive pericarditis.
Kasashima, Satomi; Matsumoto, Yasushi; Kawashima, Atsuhiro; Kurose, Nozomu; Ozaki, Satoru; Yamamoto, Hinako; Kasashima, Fuminori; Takemura, Hirofumi; Ikeda, Hiroko.
Afiliación
  • Kasashima S; Department of Clinical Laboratory Science, Graduate School of Health Science, Kanazawa University, Kanazawa, Japan; Department of Pathology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan; Department of Clinical Laboratory, Kanazawa Medical Center, Kanazawa, Japan. Electron
  • Matsumoto Y; Department of Cardiovascular Surgery, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan.
  • Kawashima A; Department of Pathology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan; Department of Clinical Laboratory, Kanazawa Medical Center, Kanazawa, Japan.
  • Kurose N; Department of Pathology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan; Department of Clinical Laboratory, Kanazawa Medical Center, Kanazawa, Japan.
  • Ozaki S; Department of Clinical Laboratory Science, Graduate School of Health Science, Kanazawa University, Kanazawa, Japan.
  • Yamamoto H; Department of Clinical Laboratory Science, Graduate School of Health Science, Kanazawa University, Kanazawa, Japan.
  • Kasashima F; Department of Cardiovascular Surgery, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan.
  • Takemura H; Department of Cardiovascular Surgery, Kanazawa University Hospital, Kanazawa, Japan.
  • Ikeda H; Department of Pathology, Kanazawa University Hospital, Kanazawa, Japan.
Cardiovasc Pathol ; 72: 107665, 2024.
Article en En | MEDLINE | ID: mdl-38825060
ABSTRACT

AIM:

Constrictive pericarditis (CP) is characterised by scarring fibrosis and a loss of pericardial elasticity, which causes heart failure. IgG4 (immunoglobulin G4)-related disease (IgG4-RD) is a systemic fibro-inflammatory disease characterised by the infiltration of IgG4-immunopositive plasmacytes and high serum IgG4 levels that frequently shape tumorous lesions. Although pericardial involvement of IgG4-RD is rare, with indications of CP, pericardial effusion and irregular masses, the clinical and pathological features remain unclear. In this study, we examined the relationship between CP and IgG4-RD.

METHODS:

Among 35 thick-walled CP cases (histologically pericardial thickening ≥2 mm), eight cases were aetiology identified. Using the diagnostic criteria for IgG4-RD, 11 cases were classified as IgG4-CP, whereas the remainder were considered true idiopathic CP (16 cases) and the clinical pathological features were evaluated.

RESULTS:

Compared with the other groups, the IgG4-CP group was more common in men and associated with low-grade fever and massive pericardial effusion with frequent recurrence. Deaths resulting from heart failure occurred in a few cases of the IgG4-CP group, but not in other groups. An increase in C-reactive protein and a high positivity rate of anti-nuclear antibodies frequently occurred in the IgG4-CP group. Histologically, the IgG4-CP group included lymphoid follicle, eosinophil infiltration and few calcifications.

CONCLUSIONS:

Pericardial IgG4-RD occurs not only as nodular lesions, but also as thick-walled CP, and accounts for approximately 40% of thick-walled CP cases of unknown cause. The predominant clinical characteristic was refractory and recurrent pericardial effusion. Recognising IgG4-RD as a cause of CP is important to initiate appropriate therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derrame Pericárdico / Pericarditis Constrictiva / Inmunoglobulina G / Enfermedad Relacionada con Inmunoglobulina G4 Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Pathol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / PATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derrame Pericárdico / Pericarditis Constrictiva / Inmunoglobulina G / Enfermedad Relacionada con Inmunoglobulina G4 Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Pathol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / PATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos