Coronary Vasculitis in a Patient With IgG4RD and Possible EGPA Presenting With Acute Coronary Syndrome
Bibliographic record
Abstract
BACKGROUND: IgG4-related disease (IgG4RD) is a systemic inflammatory disorder that can rarely affect the coronary arteries, leading to acute coronary syndrome (ACS). CASE SUMMARY: A 54-year-old man with IgG4RD and possible cytoplasmic antineutrophil cytoplasmic antibody vasculitis presented with exertional chest pain. An electrocardiogram showed T-wave inversions, and rising troponin levels confirmed ACS. Imaging revealed right coronary artery dissection and left circumflex aneurysmal remodeling, consistent with vasculitis-related coronary pathology. He was treated with antiplatelet therapy, corticosteroids, and rituximab, leading to symptom resolution and a significant reduction in IgG4 levels. DISCUSSION: This case highlights the complexity of ACS secondary to IgG4RD-associated vascular disease. Coronary involvement in IgG4RD remains under-recognized, necessitating a high index of suspicion and multimodal imaging for diagnosis. The successful use of rituximab underscores its potential in managing IgG4-related cardiovascular manifestations. TAKE-HOME MESSAGES: IgG4RD can present with ACS due to coronary vasculitis or dissection. Multidisciplinary collaboration and immunosuppressive therapy are key to optimal management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".