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IgG4関連疾患(IgG4-related disease:IgG4-RD)の血管病変は腸骨動脈や腎動脈下腹部大動脈が一般的であり,冠動脈病変はまれとされている。今回我々は,冠動脈CT angiography(coronary CT angiography:CCTA)にて左前下行枝や右冠動脈周囲に軟部影を認めた患者がIgG4-RDと診断され,プレドニゾロン内服にて軟部影の縮小を認めた症例を経験した。IgG4関連冠動脈周囲炎の既報や冠動脈周囲軟部影の鑑別疾患などと合わせて,若干の文献的考察を加えて報告する。
We report a case of a man in his 70s who was diagnosed with IgG4-related coronary periarteritis. Although coronary periarteritis is rare among IgG4-related diseases, it has the potential to cause coronary artery stenosis. When a patient with IgG4-related disease presents with symptoms of angina, coronary CT angiography may be useful. When soft tissue around the coronary arteries are found, IgG4-related disease should be included in the differential diagnosis, and differentiation should be carried out in conjunction with a systemic evaluation.

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