Evidence map›Paper›PMID 41790067›Full record

ArticleJACC. Case reports2026

IgG4-Related Disease Presenting With Diffuse Coronary Atherosclerosis Characterized by Marked Lipid-Rich Necrotic Core Burden.

Francisco X Elisarraras, Robert A Pelberg, Jacob S Roberts, Jay A Shah, Jeffrey Xia, Sammy Sayed, Norman E Lepor, Jairo Aldana-Bitar, Ronald P Karlsberg, Geoffrey Cho

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Francisco X ElisarrarasUniversity of California-Los Angeles Health, Los Angeles, California, USA. Electronic address: felisarraras@mednet.ucla.edu.
Robert A PelbergElucid Bioimaging, Boston, Massachusetts, USA.
Jacob S RobertsDivision of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Jay A ShahUniversity of California-Los Angeles Health, Los Angeles, California, USA.
Jeffrey XiaUniversity of California-Los Angeles Health, Los Angeles, California, USA.
Sammy SayedUniversity of California-Los Angeles Health, Los Angeles, California, USA.
Norman E LeporNational Heart Institute, Beverly Hills, California, USA; Cedars-Sinai Heart Institute, Los Angeles, California, USA.
Jairo Aldana-BitarElucid Bioimaging, Boston, Massachusetts, USA.
Ronald P KarlsbergCedars-Sinai Heart Institute, Los Angeles, California, USA; Cardiovascular Research Foundation of Southern California, Los Angeles, California, USA; David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.
Geoffrey ChoUniversity of California-Los Angeles Health, Los Angeles, California, USA; Cardiovascular Research Foundation of Southern California, Los Angeles, California, USA; David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder with multiorgan involvement, including increasingly recognized cardiovascular manifestations such as aortitis and periarteritis. Coronary involvement remains rare and is often clinically silent and poorly characterized, with most reported cases associated with pericoronary inflammation, ectasia, or aneurysmal dilation rather than diffuse high-risk atherosclerosis. CASE SUMMARY: A 63-year-old man with longstanding IgG4-RD presented with abdominal pain and no cardiac symptoms. Computed tomography demonstrated periaortic inflammation, incidental coronary calcification, and markedly elevated serum IgG4. Coronary computed tomography angiography revealed diffuse pericoronary thickening without aneurysmal dilation. Advanced plaque analysis showed an extreme coronary plaque burden dominated by lipid-rich necrotic core and noncalcified plaque, consistent with high-risk atherosclerosis. DISCUSSION: This case expands the spectrum of IgG4-related coronary involvement, demonstrating diffuse, severe, inflammation-associated atherosclerosis without ectasia or aneurysm and highlighting the disconnect between symptoms and disease burden, with potential for silent, high-risk coronary disease. TAKE-HOME MESSAGE: IgG4-RD may harbor clinically silent but high-risk coronary disease, supporting vigilance, proactive coronary imaging, aggressive immunosuppression, and intensive secondary prevention.

Indexed as

atherosclerosiscardiac riskcoronary artery disease (CAD)coronary CT angiography (CCTA)coronary periarteritishigh-risk plaqueIgG4-related disease (IgG4-RD)lipid-rich necrotic core (LRNC)plaque characterizationprimary preventionrisk factorsecondary prevention

Identifiers

PMID41790067
PMCPMC13080660

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.