A case of IgG4-related kidney disease complicated by eosinophilic lung disease

CEN Case Reports
Hiroki AdachiHitoshi Yokoyama

Abstract

IgG4-related disease is a systemic chronic inflammatory disorder characterized by a high blood level of IgG4 and the organ injuries by marked infiltration of IgG4-positive plasma cells and fibrosis. A 71-year-old male was hospitalized for a cough, malaise and anorexia. IgG4-related disease was suspected due to marked elevation of the serum IgG4 level. However, on lung biopsy, only eosinophil infiltration was demonstrated with no plasma cell infiltration. Otherwise abdominal contrast-enhanced CT showed mild enlargement of the bilateral kidneys and many differed contrasted areas and FDG PET-CT. Moreover, renal biopsy specimens showed typical tubulointerstitial nephritis with a large number of IgG4-positive plasma cells infiltration (the IgG4/IgG-positive cell rate, 89 %) and fibrosis. We diagnosed this patient as typical IgG4-related kidney disease. He was treated by the moderate dose of prednisolone (0.8 mg/kg/day) alone, and showed prompt response in the clinical condition, and both the lung and kidney lesions. In this case, it was useful for diagnosis of IgG4-related diseases to evaluate an image such as abdominal contrast-enhanced CT and FDG PET-CT. Our case might be one of the possible patterns of IgG4-related lung diseases....Continue Reading

References

Nov 1, 1992·Internal Medicine·M TakekawaA Yachi
Oct 1, 1987·Proceedings of the National Academy of Sciences of the United States of America·H D CampbellI G Young
Nov 1, 1994·American Journal of Respiratory and Critical Care Medicine·J N Allen, W B Davis
Mar 10, 2001·The New England Journal of Medicine·H HamanoK Kiyosawa
Jan 23, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Shin-ichi TakedaEisuke Takazakura
Nov 10, 2009·The American Journal of Surgical Pathology·Yoh ZenYasuni Nakanuma
Dec 3, 2010·Journal of Clinical and Experimental Hematopathology : JCEH·Masaru KojimaShigeo Nakamura
Dec 3, 2010·Current Opinion in Rheumatology·Arezou Khosroshahi, John H Stone
Apr 20, 2011·The American Journal of Surgical Pathology·Vikram DeshpandeJohn H Stone
Sep 8, 2011·Clinical and Experimental Nephrology·Mitsuhiro KawanoTakao Saito
Feb 10, 2012·The New England Journal of Medicine·John H StoneVikram Deshpande
May 24, 2013·Kidney International·Takako SaekiIchiei Narita

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. Here is the latest research on AN.