Khoo Jeremy F, Batt Michael, Stimpson Paul, Safdar Adnan
Department of Otolaryngology, Monash Health, Melbourne, Victoria, Australia.
Head Neck. 2014 Jun;36(6):E57-9. doi: 10.1002/hed.23519. Epub 2014 Jan 22.
Granuloma of the upper aerodigestive tract is a rare presentation of immunoglobulin-G4 (IgG4)-related disease. Since the disease process was defined in 2003, only 2 cases affecting the laryngopharynx have been reported in the literature.
A 62-year-old white man presented with persistent productive cough of brown sputum, globus symptoms, dysphagia, odynophagia, dysphonia, otalgia, and general malaise over a period of 2 months. Investigations revealed IgG4-positive plasma cell granuloma of the supraglottic region. This was successfully treated with oral corticosteroids.
Because IgG4 testing is not performed routinely, management recommendations have been poorly defined. We reviewed the literature and discuss herein the clinical characteristics, pathology, diagnosis, and management. The authors theorize that IgG4-related disease involving the larynx and pharynx may be more common than suggested by the paucity of reported cases.
上消化道气道肉芽肿是免疫球蛋白G4（IgG4）相关疾病的一种罕见表现。自2003年该疾病过程被定义以来，文献中仅报道了2例累及喉咽的病例。
一名62岁白人男性在2个月内出现持续的棕色痰性咳嗽、咽部异物感、吞咽困难、吞咽疼痛、声音嘶哑、耳痛和全身不适。检查发现声门上区IgG4阳性浆细胞肉芽肿。经口服糖皮质激素治疗成功。
由于未常规进行IgG4检测，管理建议尚不明确。我们回顾了文献并在此讨论其临床特征、病理学、诊断和管理。作者推测，累及喉和咽的IgG4相关疾病可能比报道病例的稀缺性所显示的更为常见。
