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IgG4-related Disease with Bone Marrow Involvement
Akifumi Ichiki1, Norisato Hashimoto, Tomoki Ueda
1Department of Hematology/Oncology, Tokai University Hachioji Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|August 16, 2016
Summary
This case study highlights IgG4-related disease (IgG4-RD) affecting bone marrow, a rare manifestation. Diagnosis was aided by imaging and biopsy, with successful treatment using prednisolone.
Area of Science:
- Immunology
- Oncology
- Radiology
Background:
- Immunoglobulin G4-related disease (IgG4-RD) is a multisystem fibroinflammatory condition.
- Bone marrow involvement in IgG4-RD is uncommon but can present with anemia.
Observation:
- A 61-year-old woman presented with anemia, submandibular gland swelling, and lymphadenopathy.
- Initial diagnosis of IgG4-related disease was confirmed via lymph node biopsy.
- Progressive anemia and gland swelling were noted.
Findings:
- 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed bone marrow involvement.
- Bone marrow biopsy confirmed IgG4-related disease infiltration.
- Prednisolone treatment led to rapid improvement in anemia and submandibular gland swelling.
Implications:
- This case underscores the utility of FDG-PET/CT and bone marrow biopsy in diagnosing rare IgG4-RD bone marrow involvement.
- Early diagnosis and treatment of IgG4-RD with bone marrow involvement are crucial for patient outcomes.
- Highlights the importance of considering IgG4-RD in patients with unexplained anemia and systemic symptoms.
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