Cargando…

A case report of IgG4-related respiratory disease with pleural effusion and a literature review

RATIONALE: IgG4-related respiratory disease (IgG4-RRD) is a chronic autoimmune disease that affects the respiratory system and organs outside the respiratory system. This study explored the diagnosis and treatment of a case of IgG4-RRD with unilateral pleural effusion diagnosed using medical thoraco...

Descripción completa

Detalles Bibliográficos
Autores principales: Guo, Qing, Ren, Yue, Wang, Quanyi, Pei, Hongyun, Jiang, Shenghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9333542/
https://www.ncbi.nlm.nih.gov/pubmed/35905235
http://dx.doi.org/10.1097/MD.0000000000029338
_version_ 1784758900686323712
author Guo, Qing
Ren, Yue
Wang, Quanyi
Pei, Hongyun
Jiang, Shenghua
author_facet Guo, Qing
Ren, Yue
Wang, Quanyi
Pei, Hongyun
Jiang, Shenghua
author_sort Guo, Qing
collection PubMed
description RATIONALE: IgG4-related respiratory disease (IgG4-RRD) is a chronic autoimmune disease that affects the respiratory system and organs outside the respiratory system. This study explored the diagnosis and treatment of a case of IgG4-RRD with unilateral pleural effusion diagnosed using medical thoracoscopy, and provides an associated literature review. This report summarizes the clinical characteristics of IgG4-RRD involving the pleura to improve the diagnosis of this disease. PATIENT CONCERNS: A 39-year-old man presented with a 2-week history of cough and chest tightness. Both physical examination and imaging supported the presence of left pleural effusion. DIAGNOSIS: Medical electronic thoracoscopy was performed to obtain a pleural biopsy, which showed lymphoplasmacytic infiltration, 40 IgG4+ plasma cells per High Power Field (HPF) on microscopy, IgG4/IgG ratio >50%, phlebitis obliterans, and storiform fibrosis. The final diagnosis was IgG4-RRD. INTERVENTIONS AND OUTCOMES: The patient was treated with methylprednisolone, after which his symptoms improved, and he was discharged. Oral hormone therapy was continued outside the hospital. After 4 months, the patient returned to the hospital and his condition had improved significantly. LESSONS: Pleural involvement in IgG4-RRD is rare, and its diagnosis depends on pleural biopsy. Thoracoscopy usually reveals pleural thickening, pleural nodules, and milky white plaques.
format Online
Article
Text
id pubmed-9333542
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-93335422022-08-03 A case report of IgG4-related respiratory disease with pleural effusion and a literature review Guo, Qing Ren, Yue Wang, Quanyi Pei, Hongyun Jiang, Shenghua Medicine (Baltimore) Research Article RATIONALE: IgG4-related respiratory disease (IgG4-RRD) is a chronic autoimmune disease that affects the respiratory system and organs outside the respiratory system. This study explored the diagnosis and treatment of a case of IgG4-RRD with unilateral pleural effusion diagnosed using medical thoracoscopy, and provides an associated literature review. This report summarizes the clinical characteristics of IgG4-RRD involving the pleura to improve the diagnosis of this disease. PATIENT CONCERNS: A 39-year-old man presented with a 2-week history of cough and chest tightness. Both physical examination and imaging supported the presence of left pleural effusion. DIAGNOSIS: Medical electronic thoracoscopy was performed to obtain a pleural biopsy, which showed lymphoplasmacytic infiltration, 40 IgG4+ plasma cells per High Power Field (HPF) on microscopy, IgG4/IgG ratio >50%, phlebitis obliterans, and storiform fibrosis. The final diagnosis was IgG4-RRD. INTERVENTIONS AND OUTCOMES: The patient was treated with methylprednisolone, after which his symptoms improved, and he was discharged. Oral hormone therapy was continued outside the hospital. After 4 months, the patient returned to the hospital and his condition had improved significantly. LESSONS: Pleural involvement in IgG4-RRD is rare, and its diagnosis depends on pleural biopsy. Thoracoscopy usually reveals pleural thickening, pleural nodules, and milky white plaques. Lippincott Williams & Wilkins 2022-07-29 /pmc/articles/PMC9333542/ /pubmed/35905235 http://dx.doi.org/10.1097/MD.0000000000029338 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Guo, Qing
Ren, Yue
Wang, Quanyi
Pei, Hongyun
Jiang, Shenghua
A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title_full A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title_fullStr A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title_full_unstemmed A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title_short A case report of IgG4-related respiratory disease with pleural effusion and a literature review
title_sort case report of igg4-related respiratory disease with pleural effusion and a literature review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9333542/
https://www.ncbi.nlm.nih.gov/pubmed/35905235
http://dx.doi.org/10.1097/MD.0000000000029338
work_keys_str_mv AT guoqing acasereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT renyue acasereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT wangquanyi acasereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT peihongyun acasereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT jiangshenghua acasereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT guoqing casereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT renyue casereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT wangquanyi casereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT peihongyun casereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview
AT jiangshenghua casereportofigg4relatedrespiratorydiseasewithpleuraleffusionandaliteraturereview