Onishi Yasutaka, Nakahara Yasuharu, Hirano Katsuya, Sasaki Shin, Kawamura Tetsuji, Mochiduki Yoshiro
Department of Respiratory Medicine National Hospital Organization Himeji Medical Center Himeji City Japan.
Respirol Case Rep. 2015 Dec 30;4(1):22-4. doi: 10.1002/rcr2.142. eCollection 2016 Mar.
A 67-year-old man with a history of asbestos exposure and rounded atelectasis complained of cough and swelling in the left submandibular region. Computed tomography showed an increase in size of the right lower lung lobe lesion, which was recognized as the pre-existing rounded atelectasis, as well as swelling of the pancreas and submandibular glands. Biopsy from a submandibular gland and the pulmonary lesion led to a diagnosis of immunoglobulin G4-related disease (IgG4-RD). IgG4-RD is a recently recognized disease that was first reported as an autoimmune disease; however, some reports have indicated another pathogenesis of an allergic nature that is characterized by type 2 helper T cell (Th2) inflammation. Additionally, it is recognized that long-term exposure to asbestos can cause immune dysregulation. Here we present a case of IgG4-RD associated with asbestos-related pleural disease. Asbestos-induced immune dysregulation may be one etiology of IgG4-RD.
一名有石棉接触史且患有圆形肺不张的67岁男性，主诉左下颌下区咳嗽和肿胀。计算机断层扫描显示右下肺叶病变增大，该病变被认为是既往存在的圆形肺不张，同时胰腺和下颌下腺也有肿胀。对下颌下腺和肺部病变进行活检后诊断为免疫球蛋白G4相关疾病（IgG4-RD）。IgG4-RD是一种最近才被认识的疾病，最初被报道为自身免疫性疾病；然而，一些报告指出了另一种具有过敏性本质的发病机制，其特征为2型辅助性T细胞（Th2）炎症。此外，人们认识到长期接触石棉可导致免疫失调。在此，我们报告一例与石棉相关胸膜疾病相关的IgG4-RD病例。石棉诱导的免疫失调可能是IgG4-RD的病因之一。
