Nishimura Mizuki, Kamisawa Terumi, Kitahara Yasuyuki, Nishizawa Akihiro, Tabata Taku, Hara Seiichi, Kuruma Sawako, Chiba Kazuro, Fujiwara Takashi, Kuwata Go, Egashira Hideto, Koizumi Koichi, Fujiwara Junko, Arakawa Takeo, Momma Kumiko
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Japan.
Intern Med. 2012;51(13):1705-7. doi: 10.2169/internalmedicine.51.7378. Epub 2012 Jul 1.
A 79-year-old man had a 3.5-year history of edema of the lower extremities of unknown etiology. Abdominal computed tomography showed a soft tissue mass around the abdominal aorta, and the biopsy revealed dense fibrosis with abundant infiltration of IgG4-positive plasma cells. His serum IgG4 level was increased to 188 mg/dL. His lower extremity edema was induced by stenosis of the inferior vena cava (IVC) due to the mass. With a diagnosis of IgG4-related retroperitoneal fibrosis, he was treated with steroid, and the leg edema decreased with improvement of patency of the IVC and reduction of the soft tissue mass.
一名79岁男性有3.5年不明原因的下肢水肿病史。腹部计算机断层扫描显示腹主动脉周围有一个软组织肿块，活检显示致密纤维化，伴有大量IgG4阳性浆细胞浸润。他的血清IgG4水平升高至188mg/dL。他的下肢水肿是由肿块导致的下腔静脉狭窄引起的。诊断为IgG4相关腹膜后纤维化后，他接受了类固醇治疗，随着下腔静脉通畅情况的改善和软组织肿块的缩小，腿部水肿减轻。
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