IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease

We herein report a 65-year-old man with elevated serum IgG4 levels, enlarged thyroid, and renal dysfunction, mimicking IgG4-related disease (IgG4-RD). The definitive diagnosis of IgG4-RD was not established because a tissue biopsy revealed no IgG4-positive cell infiltration or fibrosis. The presence...

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Autores principales: Funada, Masashi, Nakano, Kazuhisa, Miyata, Hiroko, Nawata, Aya, Tanaka, Yoshiya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086311/
https://www.ncbi.nlm.nih.gov/pubmed/32115519
http://dx.doi.org/10.2169/internalmedicine.3839-19
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author Funada, Masashi
Nakano, Kazuhisa
Miyata, Hiroko
Nawata, Aya
Tanaka, Yoshiya
author_facet Funada, Masashi
Nakano, Kazuhisa
Miyata, Hiroko
Nawata, Aya
Tanaka, Yoshiya
author_sort Funada, Masashi
collection PubMed
description We herein report a 65-year-old man with elevated serum IgG4 levels, enlarged thyroid, and renal dysfunction, mimicking IgG4-related disease (IgG4-RD). The definitive diagnosis of IgG4-RD was not established because a tissue biopsy revealed no IgG4-positive cell infiltration or fibrosis. The presence of an M peak in the β fraction, Bence Jones protein in urine, and progressive anemia suggested multiple myeloma (MM). The κ/λ ratio was >100, tumor plasma cells were present at >20% in bone marrow, and immunostaining revealed IgG4-positive plasma cells; therefore, he was diagnosed with IgG4-type MM. Patients with elevated IgG4 levels with no significant mass lesions should undergo systemic examinations to exclude malignancy.
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spelling pubmed-70863112020-03-26 IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease Funada, Masashi Nakano, Kazuhisa Miyata, Hiroko Nawata, Aya Tanaka, Yoshiya Intern Med Case Report We herein report a 65-year-old man with elevated serum IgG4 levels, enlarged thyroid, and renal dysfunction, mimicking IgG4-related disease (IgG4-RD). The definitive diagnosis of IgG4-RD was not established because a tissue biopsy revealed no IgG4-positive cell infiltration or fibrosis. The presence of an M peak in the β fraction, Bence Jones protein in urine, and progressive anemia suggested multiple myeloma (MM). The κ/λ ratio was >100, tumor plasma cells were present at >20% in bone marrow, and immunostaining revealed IgG4-positive plasma cells; therefore, he was diagnosed with IgG4-type MM. Patients with elevated IgG4 levels with no significant mass lesions should undergo systemic examinations to exclude malignancy. The Japanese Society of Internal Medicine 2020-03-01 /pmc/articles/PMC7086311/ /pubmed/32115519 http://dx.doi.org/10.2169/internalmedicine.3839-19 Text en Copyright © 2020 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal 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
Funada, Masashi
Nakano, Kazuhisa
Miyata, Hiroko
Nawata, Aya
Tanaka, Yoshiya
IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title_full IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title_fullStr IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title_full_unstemmed IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title_short IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
title_sort igg4-type multiple myeloma with diffuse enlargement of the thyroid requiring differentiation from igg4-related disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086311/
https://www.ncbi.nlm.nih.gov/pubmed/32115519
http://dx.doi.org/10.2169/internalmedicine.3839-19
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