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ISSN 0016-3813 (Print)

2011, Number 6

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Gac Med Mex 2011; 147 (6)

Immunoglobulin G4-associated to multiorganic lymphoproliferative disease

Bourlon MT, Chapa M, Chablé MF, Hernández CJ

Language: Spanish
References: 10
Page: 545-550
PDF size: 763.91 Kb.


ABSTRACT

We report a case of a woman with lymphoproliferative multiorganic immunoglobulin G4 (IgG4) related disease with extensive involvement showing dacryoadenitis, sialoadenitis, parotiditis, pancreatitis, pneumonitis, lymphadenopathy and immune thrombocytopenic purpura. Serum elevation of acute phase reactant, polyclonal hypergammaglobulinemia, positivity for antinuclear antibodies and rheumatoid factor was found. Hystologically plasma cell infiltration was demonstrated on glandular and lymphatic tissue and immunochemistry was positive for IgG4 in › 30%. Immunosuppressive treatment with steroids and azathioprine was given with an excellent clinical response, the marked radiologic evidence of improvement and the decrease in inflammatory makers that conducted to symptom remission are shown in the text.


REFERENCES

  1. Aalberse RC, Stapel SO, Schuurman J, Rispens T. Immunoglobulin G4: an odd antibody. Clin Exp Allergy. 2009;39:469-77.

  2. Kamisawa T. IgG4-positive plasma cells specifically infiltrate various organs in autoimmune pancreatitis. Pancreas. 2004;29:167-8.

  3. Neild GH, Rodríguez-Justo M, Wall C, Connolly JO. Hyper-IgG4 disease: report and characterisation of a new disease. BMC Med. 2006;4:23.

  4. Montefusco PP, Geiss AC, Bronzo RL, Randall S, Kahn E, McKinley MJ. Sclerosing cholangitis, chronic pancreatitis, and Sjögren´s syndrome: a syndrome complex. Am J Surg. 1984;147:822-6.

  5. Kamisawa T, Okamoto A. IgG4-related sclerosing disease. World J Gastroenterol. 2008;14(25):3948-55.

  6. Raina A, Yadav D, Krasinskas AM, et al. Evaluation and management of autoimmune pancreatitis:experience at a large US center. Am J Gastroenterol. 2009;109(9):2295.

  7. Yamamoto M, Harada S, Ohara M, et al. Clinical and pathological differences between Mikulicz´s disease and Sjogren´s syndrome. Rheumatology. 2005;44:227-34.

  8. Kamisawa T, Takuma K, Kuruma S, et al. Lacrimal gland fuction in autoimmune pancreatitis. Inter Med. 2009;48:939-43.

  9. Ohara H, Nakazawa T, Sano H, et al. Systemic extrapancreatic lesions associated with autoimmune pancreatitis. Pancreas. 2005;31(3):232-7.

  10. Kastendieck H, Hüsselmann H. Xanthofibrogranulomatosis. Classification, localization, morphology, pathogenesis. Virchows Arch A Pathol Anat Histol. 1978;380(3):237-59.




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