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Abstract

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Article in Japanese

Case Report

A case of IgG4-related disease with abnormal chest shadow, thirst, and polyuria during remission of autoimmune pancreatitis

Takashi Umedaa  Yoshinori Taninoa  Kenichi Misaa  Atsuro Fukuharaa  Bunpei Kanarib  Yoko Shibataa 

aDepartment of Pulmonary Medicine, School of Medicine, Fukushima Medical University
bDepartment of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University

ABSTRACT

A 75-year-old man presented to our hospital with dry cough, general fatigue, thirst, and polyuria. Four years previously, he had been diagnosed with autoimmune pancreatitis and treated with 30mg/day of prednisolone, which had been tapered to 1mg/day 5 months previously. Chest computed tomography revealed infiltrative shadow in both lungs, and he was admitted. Transbronchial lung biopsy indicated a possible diagnosis of IgG4-related respiratory disease. Head magnetic resonance imaging revealed swelling of the pituitary stalk and loss of high signal intensity in the posterior pituitary on T1-weighted image. Based on the imaging findings and endocrinology examination, we diagnosed the patient as having IgG4-related hypophysitis and central diabetes insipidus. We increased his prednisolone and started desmopressin. Improvement of imaging findings and symptoms was observed.This is a rare case in which IgG4-related respiratory disease and hypophysitis occurred during remission of autoimmune pancreatitis.

KEYWORDS

IgG4-related disease  IgG4-related respiratory disease  Hypophysitis  Central diabetes insipidus 

Received 27 Aug 2018 / Accepted 8 May 2019

AJRS, 8(4): 288-292, 2019

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