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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".