Yamamoto Hiroshi, Yasuo Masanori, Nomura Yayoi, Agatsuma Toshihiko, Ushiki Atsuhito, Yokoyama Toshiki, Urushihata Kazuhisa, Hanaoka Masayuki, Koizumi Tomonobu, Iwaya Mai, Yoshizawa Akihiko, Kawakami Satoshi, Hamano Hideaki, Kawa Shigeyuki, Kubo Keishi
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2011;50(24):3023-6. doi: 10.2169/internalmedicine.50.6220. Epub 2011 Dec 15.
A 66-year-old man was diagnosed with autoimmune pancreatitis in February 2009 and started 40 mg of oral prednisolone followed by a maintenance dose of 5 mg daily. The patient developed a cough in October 2010 and visited our division. He had a high serum concentration of immunoglobulin (Ig) G4 and his chest computed tomography showed airway stenosis without bilateral hilar lymphadenopathy (BHL). The bronchial biopsy specimens revealed lymphoplasmacytic infiltrations with IgG4-positive/IgG-positive plasma cells of more than 50%. Thus, we diagnosed the airway lesion with IgG4-related airway involvement. This is the first report of a patient with IgG4-related airway involvement without BHL.
一名66岁男性于2009年2月被诊断为自身免疫性胰腺炎，并开始口服40毫克泼尼松龙，随后每日维持剂量为5毫克。该患者于2010年10月出现咳嗽并前来我科就诊。他的血清免疫球蛋白（Ig）G4浓度较高，胸部计算机断层扫描显示气道狭窄，无双侧肺门淋巴结肿大（BHL）。支气管活检标本显示淋巴细胞和浆细胞浸润，IgG4阳性/I gG阳性浆细胞超过50%。因此，我们诊断该气道病变为IgG4相关性气道受累。这是首例无BHL的IgG4相关性气道受累患者的报告。
