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Immunoglobulin G4-Related Disease: A Case Report
Basavaraj Jatteppanvar1, Pradeep Chakravarthy1, Mani Teja K1
1Internal Medicine, All India Institute of Medical Sciences, Rishikesh, IND.
Cureus
|December 16, 2022
Summary
Immunoglobulin G4-related disease (IgG4 RD) presents challenges in diagnosis due to varied symptoms. This case highlights IgG4 RD in an elderly male with salivary gland enlargement, successfully treated with corticosteroids.
Area of Science:
- Rheumatology
- Immunology
- Ophthalmology
Background:
- Immunoglobulin G4-related disease (IgG4 RD) is a multisystemic fibroinflammatory condition with a generally good prognosis.
- Diagnosis can be challenging due to diverse clinical presentations, low physician awareness, and numerous differential diagnoses.
Observation:
- An elderly male presented with recurrent dental caries, sinusitis, dry mouth, dry eyes, and bilateral parotid gland enlargement without lymphadenopathy.
Findings:
- Elevated serum IgG4 levels were detected.
- Histopathological examination of the parotid gland revealed lymphocytic infiltrate with germinal centers and IgG4-positive plasma cells on immunohistochemistry (IHC), notably without granulomatous lesions.
Implications:
- This case underscores the importance of considering IgG4 RD in patients with seemingly disparate symptoms affecting multiple organs.
- Early diagnosis and treatment with corticosteroids can lead to significant symptomatic improvement in IgG4 RD.
- Increased awareness among healthcare providers is crucial for timely diagnosis and management of this rare condition.
Keywords:
corticosteroidsigg4 -related diseasemikulicz’s diseaseparotid gland swellingsjogrens syndrome
