Tuberculosis and Respiratory Diseases

  • 제77권2호
  • /
  • Pages.85-89
  • /
  • 2014
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지
DOI QR코드

DOI QR Code

A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease

  • Ahn, Jee Hwan (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Hong, Sun In (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Cho, Dong Hui (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Chae, Eun Jin (Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Song, Joon Seon (Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Song, Jin Woo (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • 투고 : 2014.04.17
  • 심사 : 2014.05.28
  • 발행 : 2014.08.29
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.

키워드

참고문헌

  1. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012;366:539-51. https://doi.org/10.1056/NEJMra1104650
  2. Shrestha B, Sekiguchi H, Colby TV, Graziano P, Aubry MC, Smyrk TC, et al. Distinctive pulmonary histopathology with increased IgG4-positive plasma cells in patients with autoimmune pancreatitis: report of 6 and 12 cases with similar histopathology. Am J Surg Pathol 2009;33:1450-62. https://doi.org/10.1097/PAS.0b013e3181ac43b6
  3. Zen Y, Inoue D, Kitao A, Onodera M, Abo H, Miyayama S, et al. IgG4-related lung and pleural disease: a clinicopathologic study of 21 cases. Am J Surg Pathol 2009;33:1886-93. https://doi.org/10.1097/PAS.0b013e3181bd535b
  4. Fujinaga Y, Kadoya M, Kawa S, Hamano H, Ueda K, Momose M, et al. Characteristic findings in images of extra-pancreatic lesions associated with autoimmune pancreatitis. Eur J Radiol 2010;76:228-38. https://doi.org/10.1016/j.ejrad.2009.06.010
  5. Duvic C, Desrame J, Leveque C, Nedelec G. Retroperitoneal fibrosis, sclerosing pancreatitis and bronchiolitis obliterans with organizing pneumonia. Nephrol Dial Transplant 2004; 19:2397-9. https://doi.org/10.1093/ndt/gfh050
  6. Takato H, Yasui M, Ichikawa Y, Fujimura M, Nakao S, Zen Y, et al. Nonspecific interstitial pneumonia with abundant IgG4-positive cells infiltration, which was thought as pulmonary involvement of IgG4-related autoimmune disease. Intern Med 2008;47:291-4. https://doi.org/10.2169/internalmedicine.47.0411
  7. Tanaka K, Nagata K, Tomii K, Imai Y. A case of isolated IgG4-related interstitial pneumonia: a new consideration for the cause of idiopathic nonspecific interstitial pneumonia. Chest 2012;142:228-30. https://doi.org/10.1378/chest.1389929
  8. Taniguchi T, Ko M, Seko S, Nishida O, Inoue F, Kobayashi H, et al. Interstitial pneumonia associated with autoimmune pancreatitis. Gut 2004;53:770.
  9. Wibmer T, Kropf-Sanchen C, Rudiger S, Blanta I, Stoiber KM, Rottbauer W, et al. Isolated IgG4-related interstitial lung disease: unusual histological and radiological features of a pathologically proven case. Multidiscip Respir Med 2013;8:22. https://doi.org/10.1186/2049-6958-8-22
  10. Yoo JW, Roh JH, Lim CM, Lee SD, Kim WS, Kim DS, et al. Two cases of pulmonary involvement of immunoglobulin G4 related autoimmune disease. Tuberc Respir Dis 2009;67:359-63. https://doi.org/10.4046/trd.2009.67.4.359
  11. Kwon SH, Lee YK, Shim MS, Lee HI. A case of immunoglobulin G4-related sclerosing disease mimicking lung cancer. J Korean Soc Radiol 2013;69:53-6. https://doi.org/10.3348/jksr.2013.69.1.53
  12. Park HY, Han J, Kang G, Yi CA, Chung MP. IgG4-related lung disease presenting as a consolidative mass: a case report. J Lung Cancer 2010;9:103-5. https://doi.org/10.6058/jlc.2010.9.2.103
  13. Choi IH, Jang SH, Lee S, Han J, Kim TS, Chung MP. A case report of IgG4-related disease clinically mimicking pleural mesothelioma. Tuberc Respir Dis 2014;76:42-5. https://doi.org/10.4046/trd.2014.76.1.42
  14. Kim DH, Koh KH, Oh HS, Kim SJ, Kang SH, Jung BW, et al. A case of immunoglobulin g4-related disease presenting as a pleural mass. Tuberc Respir Dis 2014;76:38-41. https://doi.org/10.4046/trd.2014.76.1.38
  15. Deshpande V, Zen Y, Chan JK, Yi EE, Sato Y, Yoshino T, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol 2012;25:1181-92. https://doi.org/10.1038/modpathol.2012.72

피인용 문헌

  1. IgG4-Related Lung Disease without Elevation of Serum IgG4 Level: A Case Report vol.79, pp.3, 2016, https://doi.org/10.4046/trd.2016.79.3.184
  2. IgG4-Related Lung Disease Associated with Usual Interstitial Pneumonia vol.10, pp.None, 2014, https://doi.org/10.2174/1874312901610010033
  3. IgG4-related disease: a case report with duration of more than 16 years and review of literature vol.5, pp.1, 2014, https://doi.org/10.1186/s40064-016-2537-2
  4. Isolated pulmonary IgG4-related disease mimicking lung malignancy vol.3, pp.3, 2014, https://doi.org/10.1259/bjrcr.20160134
  5. Clinical and pathological characteristics of IgG4-related interstitial lung disease vol.15, pp.2, 2014, https://doi.org/10.3892/etm.2017.5554
  6. A Rare Case of Adenosquamous Carcinoma Arising in the Background of IgG4-Related Lung Disease vol.53, pp.3, 2019, https://doi.org/10.4132/jptm.2019.02.21