Fatal Coronary Artery Vasculitis With Mixed Features.
| Autor: | Birsic GW; From the University of South Carolina School of Medicine, Columbia, SC., Hentschel BE; Edward Via College of Osteopathic Medicine, Auburn, AL., Overton-Hennessy ZC; Volusia County Medical Examiner's Office, Daytona Beach, FL., Ward ME, Fiester SE, Fulcher JW; Volusia County Medical Examiner's Office, Daytona Beach, FL. |
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| Jazyk: | angličtina |
| Zdroj: | The American journal of forensic medicine and pathology [Am J Forensic Med Pathol] 2021 Sep 01; Vol. 42 (3), pp. 307-310. |
| DOI: | 10.1097/PAF.0000000000000677 |
| Abstrakt: | Abstract: Atherosclerotic cardiovascular disease (ASCVD) is often investigated by medical examiners as a cause of sudden death. Because of the variation in presentation of atherosclerotic cardiovascular disease, the examiner must be cautious when assigning a final diagnosis. The presented case depended upon histologic examination of coronary artery lesions to reach an appropriate final diagnosis of vasculitis with mixed features. Autopsy findings showed hepatosplenic vasculitis with noncaseating granulomas, and multifocal diffuse coronary fibrosis with histologic findings consistent with late-stage polyarteritis nodosa (PAN). However, the patient lacked the hallmark renal involvement observed in PAN. Furthermore, the vasculitis within the liver showed a highly granulomatous appearance, more consistent with IgG4 disease. In these mixed-appearance cases with limited history, exact categorization of the disease may prove difficult to impossible. Herein, we review a differential diagnosis of classic vasculitides with a focus on those that commonly affect the coronary arteries in adults, namely, PAN. Competing Interests: The authors report no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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