Kawano Mitsuhiro, Suzuki Yasunori, Yamada Kazunori, Mizushima Ichiro, Matsumura Masami, Nakajima Kenichi, Yamagishi Masakazu, Yamaguchi Yutaka
Division of Rheumatology, Kanazawa University Hospital , Kanazawa, Ishikawa , Japan.
Mod Rheumatol. 2015 Jul;25(4):637-41. doi: 10.3109/14397595.2013.844303. Epub 2013 Oct 21.
We describe a 62-year-old woman with Sjögren's syndrome (SS) presenting with tubulointerstitial nephritis (TIN) and lymphadenopathy mimicking IgG4-related disease (IgG4-RD). Computed tomography revealed multiple swollen lymph nodes. Biopsy of the largest lymph node showed reactive lymphadenopathy with dense IgG4 positive plasma cell (IgG4 + PC) infiltration. Renal biopsy showed chronic plasma cell-rich TIN with IgG4 + PC infiltration. This case suggests that Immunoglobulin G4 immunostaining does not always support the diagnosis of IgG4-RD in the differential diagnosis between SS and IgG4-RD.
我们描述了一名62岁患有干燥综合征（SS）的女性，其表现为肾小管间质性肾炎（TIN）和淋巴结病，酷似IgG4相关性疾病（IgG4-RD）。计算机断层扫描显示多个肿大的淋巴结。最大淋巴结的活检显示为反应性淋巴结病，伴有密集的IgG4阳性浆细胞（IgG4+PC）浸润。肾活检显示为慢性富含浆细胞的TIN，伴有IgG4+PC浸润。该病例表明，在SS和IgG4-RD的鉴别诊断中，免疫球蛋白G4免疫染色并不总是支持IgG4-RD的诊断。
