Case report highlights diagnostic issues in coronary arteritis linked to IgG4 disease, suggesting imaging improvements.
A 68-year-old man with a history of abdominal aortic aneurysm presented with incidental coronary artery thickening on coronary CT angiography (CCTA). Eight years later, increased thickening was noted on CCTA and cardiac MRI, with PET/CT showing FDG avidity. Serology revealed elevated IgG4 and ESR. High-dose prednisone led to decreased wall thickening and FDG avidity; rituximab was initiated following relapse. This case highlights the challenges of diagnosing IgG4-related coronary arteritis and underscores the essential role of advanced imaging in guiding surveillance and therapy, especially in asymptomatic patients.
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Mew et al. (2026) studied this question.
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