IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry

A 66-year-old North-East Indian male presented with bilateral eyelid swelling, ptosis, and bilateral submandibular gland enlargement. Dry skin on both arms was another peculiar complaint. Contrast enhanced CT scans revealed homogenously enhancing, diffusely enlarged lacrimal glands and blood investi...

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Autores principales: Rehman, Obaidur, Das, Dipankar, Bhattacharjee, Kasturi, Venkatraman, Vatsalya, Bhattacharjee, Harsha, Deka, Apurba
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Romanian Society of Ophthalmology 2022
Materias:
Case Reports
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289777/
https://www.ncbi.nlm.nih.gov/pubmed/35935075
http://dx.doi.org/10.22336/rjo.2022.32
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author Rehman, Obaidur
Das, Dipankar
Bhattacharjee, Kasturi
Venkatraman, Vatsalya
Bhattacharjee, Harsha
Deka, Apurba
author_facet Rehman, Obaidur
Das, Dipankar
Bhattacharjee, Kasturi
Venkatraman, Vatsalya
Bhattacharjee, Harsha
Deka, Apurba
author_sort Rehman, Obaidur
collection PubMed
description A 66-year-old North-East Indian male presented with bilateral eyelid swelling, ptosis, and bilateral submandibular gland enlargement. Dry skin on both arms was another peculiar complaint. Contrast enhanced CT scans revealed homogenously enhancing, diffusely enlarged lacrimal glands and blood investigations showed raised serum IgG4 levels. Histopathology from lacrimal gland biopsy showed lymphoplasmacytic infiltrates in storiform pattern. Immunohistochemistry showed 35% plasma cells positive for IgG4. A diagnosis of IgG4-related disease was made, due to supportive histopathology, immunohistochemistry, and serum IgG4 levels. The patient showed excellent response to systemic immunomodulators. Abbreviations: IgG4-RD = IgG4-related disease, CECT = Contrast-enhanced computed tomography, ACE = Angiotensin converting enzyme, IHC = Immunohistochemistry, HPF = high power field, IgG4-ROD = IgG4-related ophthalmic disease, ACR/ EULAR = American College of Rheumatology/ European League Against Rheumatism
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spelling pubmed-92897772022-08-04 IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry Rehman, Obaidur Das, Dipankar Bhattacharjee, Kasturi Venkatraman, Vatsalya Bhattacharjee, Harsha Deka, Apurba Rom J Ophthalmol Case Reports A 66-year-old North-East Indian male presented with bilateral eyelid swelling, ptosis, and bilateral submandibular gland enlargement. Dry skin on both arms was another peculiar complaint. Contrast enhanced CT scans revealed homogenously enhancing, diffusely enlarged lacrimal glands and blood investigations showed raised serum IgG4 levels. Histopathology from lacrimal gland biopsy showed lymphoplasmacytic infiltrates in storiform pattern. Immunohistochemistry showed 35% plasma cells positive for IgG4. A diagnosis of IgG4-related disease was made, due to supportive histopathology, immunohistochemistry, and serum IgG4 levels. The patient showed excellent response to systemic immunomodulators. Abbreviations: IgG4-RD = IgG4-related disease, CECT = Contrast-enhanced computed tomography, ACE = Angiotensin converting enzyme, IHC = Immunohistochemistry, HPF = high power field, IgG4-ROD = IgG4-related ophthalmic disease, ACR/ EULAR = American College of Rheumatology/ European League Against Rheumatism Romanian Society of Ophthalmology 2022 /pmc/articles/PMC9289777/ /pubmed/35935075 http://dx.doi.org/10.22336/rjo.2022.32 Text en © The Authors.Romanian Society of Ophthalmology https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Rehman, Obaidur
Das, Dipankar
Bhattacharjee, Kasturi
Venkatraman, Vatsalya
Bhattacharjee, Harsha
Deka, Apurba
IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title_full IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title_fullStr IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title_full_unstemmed IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title_short IgG4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
title_sort igg4-related disease as multiple head and neck swellings: supported by histopathology and immunohistochemistry
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289777/
https://www.ncbi.nlm.nih.gov/pubmed/35935075
http://dx.doi.org/10.22336/rjo.2022.32
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