Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Extensive IgG4-Related Disease Presenting as Massive Pleural Effusion, Mediastinal Mass, and Mesenteric Lymphadenopathy in a 16-Year-Old Male

  • Goag, Eun Kyong (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Park, Ji Eun (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Lee, Eun Hye (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Park, Young Mok (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Kim, Chi Young (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Lee, Jung Mo (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Kim, Young Joo (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young Sam (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Kim, Se Kyu (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Chang, Joon (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Park, Moo Suk (Division of Pulmonology, Yonsei University College of Medicine) ;
  • Chung, Kyung Soo (Division of Pulmonology, Yonsei University College of Medicine)
  • Received : 2015.04.03
  • Accepted : 2015.07.15
  • Published : 2015.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

IgG4-related disease is an immune-mediated fibro-inflammatory disease, characterized by lymphoplasmacytic infiltration composed of IgG4-positive plasma cells of various organs with elevated circulating levels of IgG4. This disease is now reported with increasing frequency and usually affects middle-aged men. Massive pleural effusion in children is an uncommon feature in IgG4-related disease. Here, we report a case of a 16-year-old male patient with extensive IgG4-related disease presenting with massive pleural effusion, mediastinal mass, and mesenteric lymphadenopathy.

Keywords

References

  1. Desh pande 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
  2. Umeh ara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al. A novel clinical entity, IgG4-related disease (Ig- G4RD): general concept and details. Mod Rheumatol 2012; 22:1-14. https://doi.org/10.3109/s10165-011-0508-6
  3. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012;366:539-51. https://doi.org/10.1056/NEJMra1104650
  4. Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001;344:732-8. https://doi.org/10.1056/NEJM200103083441005
  5. Kamisawa T, Okamoto A. IgG4-related sclerosing disease. World J Gastroenterol 2008;14:3948-55. https://doi.org/10.3748/wjg.14.3948
  6. Cheuk W, Chan JK. IgG4-related sclerosing disease: a critical appraisal of an evolving clinicopathologic entity. Adv Anat Pathol 2010;17:303-32. https://doi.org/10.1097/PAP.0b013e3181ee63ce
  7. Carruthers MN, Khosroshahi A, Augustin T, Deshpande V, Stone JH. The diagnostic utility of serum IgG4 concentrations in IgG4-related disease. Ann Rheum Dis 2015;74:14-8. https://doi.org/10.1136/annrheumdis-2013-204907
  8. Khosroshahi A, Carruthers MN, Deshpande V, Unizony S, Bloch DB, Stone JH. Rituximab for the treatment of IgG4-related disease: lessons from 10 consecutive patients. Medicine (Baltimore) 2012;91:57-66. https://doi.org/10.1097/MD.0b013e3182431ef6
  9. Frulloni L, Lunardi C, Simone R, Dolcino M, Scattolini C, Falconi M, et al. Identification of a novel antibody associated with autoimmune pancreatitis. N Engl J Med 2009;361:2135-42. https://doi.org/10.1056/NEJMoa0903068
  10. Raina A, Yadav D, Krasinskas AM, McGrath KM, Khalid A, Sanders M, et al. Evaluation and management of autoimmune pancreatitis: experience at a large US center. Am J Gastroenterol 2009;104:2295-306. https://doi.org/10.1038/ajg.2009.325
  11. Choi JH, Sim JK, Oh JY, Lee EJ, Hur GY, Lee SH, et al. A case of IgG4-related disease presenting as massive pleural effusion and thrombophlebitis. Tuberc Respir Dis 2014;76:179-83. https://doi.org/10.4046/trd.2014.76.4.179
  12. Mah ajan VS, Mattoo H, Deshpande V, Pillai SS, Stone JH. IgG4-related disease. Annu Rev Pathol 2014;9:315-47. https://doi.org/10.1146/annurev-pathol-012513-104708
  13. Kato E, Takayanagi N, Ishiguro T, Kagiyama N, Shimizu Y, Sugita Y. IgG4-related pleuritis with chylothorax. Intern Med 2014;53:1545-8. https://doi.org/10.2169/internalmedicine.53.1642

Cited by

  1. The differential diagnosis of intra-abdominal tuberculosis vol.79, pp.7, 2015, https://doi.org/10.12968/hmed.2018.79.7.416
  2. IgG4-related disease with elevated adenosine deaminase in pleural effusion diagnosed clinically using thoracoscopy under local anesthesia and FDG-PET-CT vol.30, pp.None, 2020, https://doi.org/10.1016/j.rmcr.2020.101066
  3. Refractory IgG4-related Pleural Disease with Chylothorax: A Case Report and Literature Review vol.60, pp.13, 2021, https://doi.org/10.2169/internalmedicine.6313-20
  4. Multiple pleural nodules diagnosed as IgG4-related disease: a case report vol.7, pp.1, 2015, https://doi.org/10.1186/s40792-021-01166-y