{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:01:05Z","timestamp":1780092065665,"version":"3.54.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T00:00:00Z","timestamp":1649376000000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>IgG4-related disease (IgG4-RD) is an autoimmune condition affecting almost every organ system, with an early inflammatory phase and later fibrotic consequences. Vascular manifestations, particularly, large-vessel involvement in IgG4-RD, are well described. However, important IgG4-related effects on medium-sized arteries and the pericardium are less well recognized. These less frequently reported cardiovascular effects of IgG4-RD include coronary artery stenosis, pericardial disease, cardiac masses, and valvular heart disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>This case series focuses on three patients that demonstrate the cardiovascular effects of IgG4-RD and the pitfalls and importance of early diagnosis. Cases 1 and 2 presented with cardiac manifestations prior to more typical organ systems being affected which led to a delay in diagnosis. Case 1 presented with an acute myocardial infarction secondary to IgG4-RD of the coronary arteries and Case 2 presented with pericarditis which progressed to pericardial constriction due to IgG4-RD. Case 3 already had a diagnosis of IgG4-RD from a prior renal biopsy which raised the index of suspicion that his pericardial disease and thoracic mass were also related to IgG4-RD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Cardiac manifestations of IgG4-RD remain under-recognized and include coronary artery and pericardial disease. These manifestations often precede more typical manifestations in other organ systems. Recognizing cardiac manifestations of IgG4-RD on cardiac imaging can raise clinical suspicion and act as a catalyst to ascertain a confirmatory diagnosis. Early diagnosis and treatment are crucial to prevent potentially fatal outcomes and irreversible fibrosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac153","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T06:46:23Z","timestamp":1649400383000},"source":"Crossref","is-referenced-by-count":22,"title":["Cardiac manifestations of IgG4-related disease: a case series"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4260-2793","authenticated-orcid":false,"given":"Seshika","family":"Ratwatte","sequence":"first","affiliation":[{"name":"Department of Cardiology, Concord Repatriation and General Hospital, Hospital Road, Concord, NSW 2139, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation and General Hospital, Hospital Road, Concord, NSW 2139, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd John","family":"Ridley","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, Australia"},{"name":"Department of Radiology, Concord Repatriation and General Hospital, Concord, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Concord Repatriation and General Hospital, Concord, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Naoum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation and General Hospital, Hospital Road, Concord, NSW 2139, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6230-5617","authenticated-orcid":false,"given":"John","family":"Yiannikas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation and General Hospital, Hospital Road, Concord, NSW 2139, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"key":"2022042507440808200_ytac153-B1","doi-asserted-by":"crossref","first-page":"iii123","DOI":"10.1093\/rheumatology\/kez667","article-title":"IgG4-related disease: a clinical perspective","volume":"59","author":"Maritati","year":"2020","journal-title":"Rheumatology"},{"key":"2022042507440808200_ytac153-B2","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1007\/s10067-020-05302-1","article-title":"Vasculitis beyond aortitis in IgG4-related disease (IgG4-RD): case report and review of the literature","volume":"40","author":"Fragoulis","year":"2021","journal-title":"Clin Rheumatol"},{"key":"2022042507440808200_ytac153-B3","doi-asserted-by":"crossref","first-page":"e3344","DOI":"10.1097\/MD.0000000000003344","article-title":"Large vessel involvement by IgG4-related disease","volume":"95","author":"Perugino","year":"2016","journal-title":"Medicine"},{"key":"2022042507440808200_ytac153-B4","doi-asserted-by":"crossref","first-page":"224","DOI":"10.2174\/1573403X15666190117101607","article-title":"Multimodalities imaging of immunoglobulin 4-related cardiovascular disorders","volume":"15","author":"Fathala","year":"2019","journal-title":"Curr Cardiol Rev"},{"key":"2022042507440808200_ytac153-B5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1136\/annrheumdis-2019-216561","article-title":"The 2019 American College of Rheumatology\/European League against rheumatism classification criteria for IgG4-related disease","volume":"79","author":"Wallace","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"2022042507440808200_ytac153-B6","doi-asserted-by":"crossref","first-page":"S142","DOI":"10.1016\/j.hlc.2021.06.117","article-title":"Unrecognised intracoronary igg4-related disease: a rare cause of two sudden cardiac deaths","volume":"30","author":"Paratz","year":"2021","journal-title":"Heart Lung Circ"},{"key":"2022042507440808200_ytac153-B7","doi-asserted-by":"crossref","first-page":"e004583","DOI":"10.1161\/CIRCIMAGING.116.004583","article-title":"IgG4-related disease with coronary arteritis","volume":"9","author":"Keraliya","year":"2016","journal-title":"Circ Cardiovasc Imaging"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac153\/43311388\/ytac153.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/4\/ytac153\/43443653\/ytac153.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/4\/ytac153\/43443653\/ytac153.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T07:44:26Z","timestamp":1650872666000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac153\/6565185"}},"subtitle":[],"editor":[{"given":"Christoph","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ali","family":"Nazmi Calik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Rizwan","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Gal","family":"Tsaban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Tinka Julia","family":"van Trier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4,13]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac153","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,4,1]]},"published":{"date-parts":[[2022,4,1]]},"article-number":"ytac153"}}