IgG4-Related Sclerosing Pericarditis in a Young Man With Recurrent Chest Pain

Many cases of immunoglobulin G4 (IgG4)–related disease involving different organ systems have been reported in the literature since the disorder was first described in patients with sclerosing pancreatitis. This report discusses an interesting case of IgG4-related cardiovascular disease that involved the pericardium and resulted in reoccurring chest pain in a 36-year-old man. The challenging diagnosis was made using established diagnostic criteria for other tissue sites and included the presence of elevated serum IgG4, pericardial infiltration by IgG4-positive plasma cells, focal phlebitis, and fibrosis. The patient's symptoms improved with immunosuppressive therapy.