Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Immunoglobulin G4-Related Myocarditis with Eosinophilic Infiltration: A Case Report

면역글로불린 G4연관 호산구 침윤성 심근염: 증례 보고

  • Hyun Woo (Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Song Soo Kim (Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Kye Taek Ahn (Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Seon Ah Jin (Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Hyeyoung Kwon (Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine)
  • 우현 (충남대학교 의과대학 충남대학교병원 영상의학과) ;
  • 김성수 (충남대학교 의과대학 충남대학교병원 영상의학과) ;
  • 안계택 (충남대학교 의과대학 충남대학교병원 심장내과) ;
  • 진선아 (충남대학교 의과대학 충남대학교병원 심장내과) ;
  • 권혜영 (충남대학교 의과대학 충남대학교병원 영상의학과)
  • Received : 2022.04.21
  • Accepted : 2023.02.10
  • Published : 2023.05.01
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Abstract

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a fibroinflammatory disorder that can involve any organ system; however, myocarditis is extremely rare. A 52-year-old male with dyspnea and chest discomfort underwent cardiac MRI that revealed edema and nodular, patchy, mesocardial and subendoardial delayed enhancement of left ventricle, suggesting myocarditis. Laboratory findings revealed elevated serum IgG4 and eosinophilia. Cardiac biopsy confirmed eosinophilic myocarditis with IgG4-positive cells. Here, we present an unusual case of IgG4-RD manifesting as eosinophilic myocarditis.

면역글로불린(immunoglobulin; 이하 Ig) G4 연관 질환은 어떤 장기도 침범할 수 있는 섬유염증성 질환이며, 심근염의 형태로 발현되는 경우는 매우 드물다. 호흡곤란과 흉통이 있는 52세 남성이 심장자기공명영상에서 좌심실벽에 부종 및 심장간막과 심내막에 반점형과 결절형 지연 조영증강을 보이는 심근염 소견을 보였다. 혈액검사상 혈청 IgG4 상승과 호산구 증가증이 동반되었으며 심장 생검으로 호산구성 심근염과 IgG4 양성 세포가 확인되었다. 이에 저자들은 IgG4 연관 질환이 호산구성 심근염으로 발현된 드문 증례를 보고하고자 한다.

Keywords

References

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