Kawano Mitsuhiro, Yamada Kazunori, Kakuchi Yasushi, Ito Kiyoaki, Hamano Ryoko, Fujii Hiroshi, Inoue Ryo, Matsumura Masami, Takahira Masayuki, Zen Yoh, Yachie Akihiro, Nakashima Akikatsu, Yamagishi Masakazu
Division of Rheumatology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, and Saiseikai Kanazawa Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
Mod Rheumatol. 2009;19(1):87-90. doi: 10.1007/s10165-008-0127-z. Epub 2008 Oct 15.
We describe a 64-year-old woman with chronic sclerosing sialadenitis and dacryoadenitis, which developed during treatment for cervical lymph node tuberculosis. Anti-tuberculosis treatment did not improve the swelling in the lacrimal and submandibular glands, and a biopsy specimen of the lacrimal gland showed inflammation, with abundant lymphoid follicles with fibrosis and granuloma without caseous necrosis. Immunohistological examination of a repeat biopsy specimen showed abundant immunoglobulin (Ig) G4-positive plasma cell infiltration. Corticosteroid therapy improved the salivary gland swelling without reactivation of the tuberculosis. This case suggests that an abnormal immunological reaction to tuberculosis may be one of the etiological candidates for IgG4-related disease.
我们描述了一名64岁患有慢性硬化性涎腺炎和泪腺炎的女性，这两种病症在其颈部淋巴结结核治疗期间出现。抗结核治疗并未改善泪腺和下颌下腺的肿胀，泪腺活检标本显示有炎症，伴有大量伴有纤维化的淋巴滤泡以及无干酪样坏死的肉芽肿。对重复活检标本进行免疫组织学检查显示有大量免疫球蛋白（Ig）G4阳性浆细胞浸润。皮质类固醇疗法改善了唾液腺肿胀，且未导致结核复发。该病例表明，对结核的异常免疫反应可能是IgG4相关疾病的病因之一。
