Takasumi Mika, Miyata Masayuki, Kuroda Masahito, Terashima Kumiko, Abe Kazumichi, Takahashi Atsushi, Kobayashi Hiroko, Tazaki Kazuhiro, Watanabe Hiroshi, Ohira Hiromasa
Department of Internal Medicine and Gastroenterology, Fukushima Red Cross Hospital, Japan.
Intern Med. 2016;55(10):1387-92. doi: 10.2169/internalmedicine.55.6202. Epub 2016 May 15.
A 63-year-old woman was referred to Fukushima Red Cross Hospital with an enlargement of the left submandibular gland and subcutaneous bleeding in the chest and legs. A diffuse enlargement of the pancreas was also detected by abdominal computed tomography, and laboratory data showed severe thrombocytopenia. She was diagnosed with IgG4-related disease (IgG4-RD) complicated with autoimmune thrombocytopenia and was treated with methylprednisolone, after which the number of platelets favorably increased. Further investigation for liver dysfunction revealed underlying primary biliary cirrhosis (PBC). We herein report a rare case of IgG4-RD overlapping PBC complicated with autoimmune thrombocytopenia.
一名63岁女性因左下颌下腺肿大及胸部和腿部皮下出血被转诊至福岛红十字医院。腹部计算机断层扫描还检测到胰腺弥漫性肿大,实验室检查数据显示严重血小板减少。她被诊断为IgG4相关性疾病(IgG4-RD)合并自身免疫性血小板减少症,并接受了甲泼尼龙治疗,之后血小板数量呈良好增加。对肝功能障碍的进一步检查发现潜在的原发性胆汁性肝硬化(PBC)。我们在此报告一例罕见的IgG4-RD重叠PBC合并自身免疫性血小板减少症的病例。