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Published on: January 16, 2013
IgG4-associated prostatitis complicating autoimmune pancreatitis
Yukihiro Yoshimura1, Shin-ichi Takeda, Yasuhiko Ieki
1Department of Internal Medicine, Kurobe City Hospital, Kurobe, Toyama.
Insights
This study reports the first case of IgG4-associated prostatitis complicating autoimmune pancreatitis in a man with benign prostatic hypertrophy. The condition presented with obstructive jaundice and elevated IgG4 levels.
Area of Science:
- Immunology
- Gastroenterology
- Urology
Background:
- Immunoglobulin G4 (IgG4)-related disease is a systemic fibroinflammatory condition.
- Autoimmune pancreatitis (AIP) is a manifestation of IgG4-related disease.
- Benign prostatic hypertrophy (BPH) is a common condition in older men.
Observation:
- A 65-year-old man with BPH developed obstructive jaundice post-prostate and salivary gland resection.
- Laboratory tests revealed elevated eosinophils and serum IgG4 levels.
- Histological examination of the prostate, salivary glands, and pancreas showed lymphocyte and plasma cell infiltration with dense fibrosis, predominantly IgG4-positive plasma cells.
Findings:
- The patient was diagnosed with IgG4-associated prostatitis complicating autoimmune pancreatitis.
- This represents the first documented case of this specific combination.
Implications:
- This case highlights the potential for IgG4-related disease to affect the prostate.
- It underscores the importance of considering IgG4-related disease in patients with unexplained obstructive jaundice and elevated IgG4.
- Further research is needed to understand the pathogenesis and clinical spectrum of IgG4-related prostatitis.
Abstract:
A 65-year-old man underwent transurethral resection of the prostate on a diagnosis of benign prostatic hypertrophy. Almost simultaneously, a diagnostic resection of minor salivary glands was performed. After the resections he suffered from obstructive jaundice. Laboratory examinations revealed an increase in eosinophils and an elevation of serum IgG4. Pancreaticoduodenectomy was performed because of the possibility of pancreatic cancer. The prostate, salivary glands and pancreas showed common histological characteristics, namely, infiltration of lymphocytes and plasma cells accompanying dense fibrosis. Most of the infiltrating plasma cells showed strong immunoreactivity to IgG4. This is the first case with IgG4-associated prostatitis complicating autoimmune pancreatitis.
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