血清IgG4升高并发心包受累，PET/CT显示斑片状（18）F-FDG摄取：IgG4相关疾病的非典型表现
Elevated Serum IgG4 Complicated by Pericardial Involvement with a Patchy (18)F-FDG Uptake in PET/CT: Atypical Presentation of IgG4-related Disease.
作者信息
Matsumiya Ryo, Hosono Osamu, Yoshikawa Noritada, Uehara Masaaki, Kobayashi Hiroshi, Oda Aya, Matsubara Erika, Tanada Shuji, Shintani Yukako, Nagayama Kazuhiro, Nakajima Jun, Tanaka Hirotoshi
机构信息
Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan.
出版信息
Intern Med. 2015;54(18):2337-41. doi: 10.2169/internalmedicine.54.4340. Epub 2015 Sep 15.
IgG4-related pericardial involvement has rarely been reported and its clinical features remain unknown. We herein report a case of a 50-year-old woman with pericarditis who presented with a fever, elevated C-reactive protein levels, elevated serum IgG4 concentrations, and thickened pericardium with a patchy (18)F-fluorodeoxyglucose (FDG) uptake. A biopsy specimen of (18)F-FDG accumulated in the mediastinal lymph nodes revealed an abundant infiltration of IgG4-bearing plasma cells without fibrosis. Moderate-dose glucocorticoids promptly resolved the physical, serological, and imaging abnormalities, thus indicating a relatively acute and reversible nature of IgG4-related pericardial involvement.
IgG4相关的心包受累鲜有报道，其临床特征尚不清楚。我们在此报告一例50岁患有心包炎的女性病例，该患者表现为发热、C反应蛋白水平升高、血清IgG4浓度升高以及心包增厚伴斑片状（18）F-氟脱氧葡萄糖（FDG）摄取。对纵隔淋巴结中积聚的（18）F-FDG进行活检，结果显示有大量含IgG4的浆细胞浸润但无纤维化。中等剂量的糖皮质激素迅速缓解了身体、血清学及影像学异常，这表明IgG4相关的心包受累具有相对急性且可逆的性质。
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