Ikeura Tsukasa, Horitani Shunsuke, Masuda Masataka, Kasai Takeshi, Yanagawa Masato, Miyoshi Hideaki, Uchida Kazushige, Takaoka Makoto, Miyasaka Chika, Uemura Yoshiko, Okazaki Kazuichi
The Third Department of Internal Medicine, Kansai Medical University, Japan.
Intern Med. 2016;55(18):2623-8. doi: 10.2169/internalmedicine.55.6919. Epub 2016 Sep 15.
A 63-year-old woman presented to our hospital with elevated levels of serum IgG4, marked wall thickening of the gallbladder, hepatomegaly, and abdominal lymphadenopathy. She experienced a recurrent fever and leg edema. Her laboratory data demonstrated anemia, hypoalbuminemia, and elevated serum levels of interleukin-6 and C-reactive protein. The patient was eventually diagnosed with IgG4-related disease according to the comprehensive diagnostic criteria, although the patient exhibited common clinical manifestations of multicentric Castleman disease such as a fever, anemia, lymphadenopathy, and elevated levels of serum interleukin-6 and C-reactive protein. This case report highlights the difficulties in differentiating between these two diseases.
一名63岁女性因血清IgG4水平升高、胆囊壁明显增厚、肝肿大和腹部淋巴结病前来我院就诊。她反复发热,伴有腿部水肿。实验室检查显示贫血、低白蛋白血症以及血清白细胞介素-6和C反应蛋白水平升高。尽管该患者表现出多中心Castleman病的常见临床表现,如发热、贫血、淋巴结病以及血清白细胞介素-6和C反应蛋白水平升高,但根据综合诊断标准最终诊断为IgG4相关疾病。本病例报告强调了鉴别这两种疾病的困难。