Mesh : Angina Pectoris, Variant / immunology physiopathology CD36 Antigens / metabolism Coronary Vasospasm / immunology Electrocardiography Heart / diagnostic imaging Humans Iodine Radioisotopes Iodobenzenes Male Metabolic Syndrome / immunology Middle Aged Tomography, Emission-Computed, Single-Photon

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Abstract:
A 54-year-old man was admitted to our hospital for evaluation of chest pain occurring at rest in the morning. ST segment depression was observed during a treadmill exercise test. Coronary angiography identified spontaneous spasm of the proximal right coronary artery, and right coronary obstruction was improved from 90% to about 50% stenosis after intracoronary administration of nitroglycerin. Myocardial iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid uptake was absent, but thallium-201 uptake during single photon emission computed tomography was normal, and neither platelet nor monocyte expression of the CD36 molecule was observed, indicating type I CD36 deficiency. High blood pressure, elevated plasma triglyceride and fasting plasma glucose levels, and low high-density lipoprotein values suggested metabolic syndrome. The final diagnosis was type I CD 36 deficiency associated with metabolic syndrome and vasospastic angina.
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