Constrictive Pericarditis Caused by Immunoglobulin G4–Related Disease

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Presentation transcript:

Constrictive Pericarditis Caused by Immunoglobulin G4–Related Disease Hiromasa Yanagi, MD, PhD, Ichiya Yamazaki, MD, PhD, Satoru Shimizu, MD, Hideo Himeno, MD, PhD, Shin-ichi Suzuki, MD, PhD, Munetaka Masuda, MD, PhD The Annals of Thoracic Surgery Volume 97, Issue 3, Pages e71-e74 (March 2014) DOI: 10.1016/j.athoracsur.2013.10.085 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Computed tomographic scan of the chest, showing marked pericardial thickening without calcification. The Annals of Thoracic Surgery 2014 97, e71-e74DOI: (10.1016/j.athoracsur.2013.10.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Results of hemodynamic cardiac catheterization. (A) Before operation, increased right ventricular end-diastolic pressure, and left ventricular end-diastolic pressure with a square root sign. (B) After operation, decrease in ventricular end-diastolic pressure, but persistence of square root sign. The Annals of Thoracic Surgery 2014 97, e71-e74DOI: (10.1016/j.athoracsur.2013.10.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Immunoglobulin G4 (IgG4) immunostain demonstrating an increased absolute count of IgG4-positive plasma cells (24 per high-power field on average) and a ratio of IgG4/IgG-positive cells of 68% (original magnification, ×400). The Annals of Thoracic Surgery 2014 97, e71-e74DOI: (10.1016/j.athoracsur.2013.10.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Cardiac magnetic resonance image, showing further improvement of ventricular diastolic function 38 days after the beginning of corticosteroid therapy. (A) 1: Systole (before operation). 2: Diastole (before operation). (B) 1: Systole (after operation). 2: Diastole (after operation). (C) 1: Systole (after steroid therapy). 2: Diastole (after steroid therapy). The Annals of Thoracic Surgery 2014 97, e71-e74DOI: (10.1016/j.athoracsur.2013.10.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions