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An unusual cause of pulmonary outflow obstruction: IgG4 deposition disease-MRI observations

  • Karthik Gadabanahalli
  • Venkatraman BhatEmail author
  • P. V. Suresh
  • N. C. Gnanadev
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Introduction

Intraluminal filling defects in the right ventricular outflow (RVOT) are often due to a thrombus or occasionally due to rare lesions like sarcoma arising from pulmonary arteries [1]. Deposition disease is a very rare cause for a thrombus like intra-cardiac luminal defect. IgG4 deposition diseases occasionally present with focal deposition of immunoglobulin deposits at various organs, including the heart [2]. MRI imaging features in the specific clinical contest may provide clue to this rare phenomenon. It is important to recognise this uncommon entity, in view of the widely differing management options.

Case report

36-year-old male presented with exertional dyspnoea and progressive loss of weight of 16 kg, over the last 1 year. He had no history of fever or any chronic illness. His physical examination was unremarkable. On echocardiography, he was found to have a filling defect in RVOT, at the level of pulmonary valve. His lab investigations revealed following parameters:...

Notes

Acknowledgements

Authors would like to thank the support of pathology departments of Narayana Health and PGIMER Chandigarh, for confirming the final diagnosis of the pathology material. Our since thanks to Dr Chinnaswamy Reddy for surgical details and Chairman of Narayana Health Dr. Devi Shetty for his guidance and support.

Compliance with ethical standards

Conflict of interest

There is no conflict of interest regarding the submitted work.

References

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    Toor AA, Ramdane BA, Joseph J, Thomas M, O’Hara C, Barlogie B, Walker P, Joseph L (2006) Cardiac nonamyloidotic immunoglobulin deposition disease. Mod Pathol 19(2):233–237CrossRefGoogle Scholar
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    Della-Torre E, Lanzillotta M, Doglioni C (2015) Immunology of IgG4-related disease. Clin Exp Immunol 181(2):191–206.  https://doi.org/10.1111/cei.12641 CrossRefGoogle Scholar
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    Carbajal H, Waters L, Popovich J, Boniuk M, Chevez-Barrios P, Marcus DM, Sessoms S (2013) IgG4 related cardiac disease. Methodist DeBakey Cardiovasc J 9(4):230–232CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Narayana HealthBengaluruIndia

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