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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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
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author Nagayasu, Atsushi
Kubo, Satoshi
Nakano, Kazuhisa
Nakayamada, Shingo
Iwata, Shigeru
Miyagawa, Ippei
Fukuyo, Shunsuke
Saito, Kazuyoshi
Tanaka, Yoshiya
author_facet Nagayasu, Atsushi
Kubo, Satoshi
Nakano, Kazuhisa
Nakayamada, Shingo
Iwata, Shigeru
Miyagawa, Ippei
Fukuyo, Shunsuke
Saito, Kazuyoshi
Tanaka, Yoshiya
author_sort Nagayasu, Atsushi
collection PubMed
description 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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spelling pubmed-61208382018-09-04 IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion Nagayasu, Atsushi Kubo, Satoshi Nakano, Kazuhisa Nakayamada, Shingo Iwata, Shigeru Miyagawa, Ippei Fukuyo, Shunsuke Saito, Kazuyoshi Tanaka, Yoshiya Intern Med Case Report 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. The Japanese Society of Internal Medicine 2018-03-09 2018-08-01 /pmc/articles/PMC6120838/ /pubmed/29526951 http://dx.doi.org/10.2169/internalmedicine.0387-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Nagayasu, Atsushi
Kubo, Satoshi
Nakano, Kazuhisa
Nakayamada, Shingo
Iwata, Shigeru
Miyagawa, Ippei
Fukuyo, Shunsuke
Saito, Kazuyoshi
Tanaka, Yoshiya
IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title_full IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title_fullStr IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title_full_unstemmed IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title_short IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion
title_sort igg4-related pleuritis with elevated adenosine deaminase in pleural effusion
topic Case Report
url 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
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