Kim A J, Ro H, Chang J H, Jung J Y, Chung W K, Park Y H, Lee H H
Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea.
Department of Surgery, College of Medicine, Gachon University, Incheon, Korea.
Transplant Proc. 2018 Oct;50(8):2572-2574. doi: 10.1016/j.transproceed.2018.02.197. Epub 2018 Mar 19.
Besides the initial description of IgG4-related pancreatic disease, other sites are now commonly involved. However, occurrence of IgG4-related disease is rare in organ transplanted patients. A 57-year-old man who received a kidney transplantation presented with recurrent dyspnea on exertion. A computed tomography scan of the chest revealed bilateral interlobular septal thickening and multiple tubular and branching small nodular lesions in the right upper lobe, and mass-like consolidation of the left middle lobe. Despite no elevation of serum IgG4 level, a percutaneous core needle biopsy on consolidative mass showed interstitial fibrosis and infiltration of IgG4-positive plasma cells to be more than > 20 per high power field. After treatment with glucocorticoids and rituximab, the consolidative mass of the left middle lobe disappeared.
