IgG4相关性疾病与系统性红斑狼疮的重叠病例

Naramala Srikanth, Biswas Sharmi, Adapa Sreedhar, Gayam Vijay, Konala Venu Madhav, Bose Subhasish

1 Adventist Medical Center Hanford, Hanford, CA, USA.

2 Weill Cornell Medicine, New York, NY, USA.

J Investig Med High Impact Case Rep. 2019 Jan-Dec;7:2324709619862297. doi: 10.1177/2324709619862297.

We are reporting a case of a 63-year-old Chinese female who presented to the rheumatology clinic with positive antinuclear antibody and unintentional weight loss along with lymphadenopathy. Further workup revealed eosinophilia, elevated anti-double stranded DNA, serum protein, and serum IgG4 (immunoglobulin G4). The patient was diagnosed with systemic lupus erythematosus. Due to the raised IgG4 level along with eosinophilia and diffuse lymphadenopathy, IgG4-related systemic disease was suspected. It was confirmed with IgG4 staining on lymph node biopsy. Our case is presenting the fact that systemic lupus erythematosus and IgG4-related disease can be present in the same patient with multiple overlapping features making accurate diagnosis challenging.

我们报告了一例63岁的中国女性病例，该患者因抗核抗体阳性、不明原因体重减轻及淋巴结病就诊于风湿病诊所。进一步检查发现嗜酸性粒细胞增多、抗双链DNA、血清蛋白及血清IgG4（免疫球蛋白G4）升高。该患者被诊断为系统性红斑狼疮。由于IgG4水平升高、嗜酸性粒细胞增多及弥漫性淋巴结病，怀疑为IgG4相关性系统性疾病。淋巴结活检IgG4染色确诊。我们的病例表明，系统性红斑狼疮和IgG4相关性疾病可同时存在于同一患者，具有多种重叠特征，使得准确诊断具有挑战性。