IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion

An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pl...

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Detalles Bibliográficos
Autores principales: Nagayasu, Atsushi, Kubo, Satoshi, Nakano, Kazuhisa, Nakayamada, Shingo, Iwata, Shigeru, Miyagawa, Ippei, Fukuyo, Shunsuke, Saito, Kazuyoshi, Tanaka, Yoshiya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120838/
https://www.ncbi.nlm.nih.gov/pubmed/29526951
http://dx.doi.org/10.2169/internalmedicine.0387-17
Descripción
Sumario:An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pleural effusion. A surgical pleural biopsy revealed that there were large numbers of IgG4-positive cells and IgG4/IgG positive cell ratio exceeded 40% in several sites. Accordingly, we diagnosed IgG4-related pleuritis and treated with the patient with glucocorticoid therapy. The ADA levels in pleural effusion can increase in IgG4-related pleuritis, and it is therefore important to perform a pleural biopsy.

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