Rheumatology International

, Volume 23, Issue 6, pp 315–318

Myocardial infarction caused by rheumatoid vasculitis: histological evidence of the involvement of T lymphocytes

  • M. Takayanagi
  • H. Haraoka
  • H. Kikuchi
  • S. Hirohata
Case Report

DOI: 10.1007/s00296-003-0310-7

Cite this article as:
Takayanagi, M., Haraoka, H., Kikuchi, H. et al. Rheumatol Int (2003) 23: 315. doi:10.1007/s00296-003-0310-7

Abstract

Rheumatoid arthritis (RA) is a chronic joint disease that can be complicated with extra-articular manifestations due to vasculitis. We describe a patient with RA who developed systemic vasculitis and died of myocardial infarction. Autopsy demonstrated vasculitis of the left anterior descendent and circumflex coronary arteries, which were narrowed or occluded with organizing thrombosis. Formation of granuloma with multinucleated giant cells was also observed in media of the circumflex artery. There was no microscopic evidence of atheroma formation in the coronary arteries. Of note, there was a follicle-like infiltration of CD45RO-positive T lymphocytes in interna of the left coronary arteries and the right renal artery. Although not frequently reported, coronary vasculitis as a cause of myocardial infarction should be considered in patients with RA. Moreover, our results suggest that infiltration of T lymphocytes might be involved in the development of rheumatoid vasculitis.

Keywords

CD45ROCoronary arteryRheumatoid arthritisT lymphocytesVasculitis

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • M. Takayanagi
    • 1
  • H. Haraoka
    • 1
  • H. Kikuchi
    • 1
  • S. Hirohata
    • 1
  1. 1.Department of Internal MedicineTeikyo University School of MedicineTokyo 173-8605Japan