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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of steroid effective pleuritis and lymphadenopathy needed to distinguish IgG4-related disease from multicentric Castleman's disease

Yu Haraa,b  Masaharu Shinkaia,b  Nobuhiro Yamaguchia  Mariko Todaa  Akihiko Kawanab  Yoshiaki Ishigatsuboc  Takeshi Kanekoa 

aRespiratory Disease Center, Yokohama City University Medical Center
bDivision of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
cDepartment of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine

ABSTRACT

This case involves a 69-year-old man whose main complaint was a right chest pain. Indicated with right pleural effusion and mediastinal and hilar lymphadenopathy by a neighboring doctor, he was admitted to our hospital. From elevated serum IgG4, interleukin (IL)-6 levels, IgG4-related disease (IgG4-RD), or multicentric Castleman's disease (MCD) were suspected. The examination of pleural effusion revealed IgG4 positive plasma cells and eosinophils. The right pleural and the mediastinal lymph node biopsy specimens revealed IgG4 positive plasma cell infiltrations. Because of the lack of anemia, thrombocytosis, and hypoalbuminemia, we concluded that the case was IgG4-RD. Generally, the histological findings of IgG4-RD and MCD were similar, and it is necessary to take these clinical findings into account. We should keep in mind the possibility of MCD in an out-patient clinic.

KEYWORDS

IgG4-related disease  Interleukin-6  Lymphadenopathy  Multicentric Castleman's disease  Pleural effusion 

Received 12 Sep 2012 / Accepted 4 Apr 2013

AJRS, 2(5): 544-549, 2013

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