Makimoto Go, Ohashi Kadoaki, Taniguchi Kohei, Soh Junichi, Taniguchi Akihiko, Miyahara Nobuaki, Toyooka Shinichi, Yoshino Tadashi, Maeda Yoshinobu, Kiura Katsuyuki
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, 700-8558, Japan.
Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho Kita-ku, Okayama, 700-8558, Japan.
Respir Med Case Rep. 2019 Sep 24;28:100938. doi: 10.1016/j.rmcr.2019.100938. eCollection 2019.
Pleural effusion is a relatively rare feature of IgG4-related disease (IgG4-RD). Here, we report a case of a 72-year-old woman who presented with pleural effusion. Although the pleural adenosine deaminase level was increased, surgical biopsy of the pleura and left inguinal lymph node indicated that the effusion was due to IgG4-RD. Active surveillance was initiated because serum IgG4 and pleural effusion naturally decreased and then completely disappeared. The patient has shown no recurrence for >4 years. This case suggests that pleural biopsy can be used to distinguish IgG4-RD from tuberculosis; moreover, some cases with pleural effusion could improve without treatment.
胸腔积液是IgG4相关疾病（IgG4-RD）相对罕见的特征。在此，我们报告一例72岁女性出现胸腔积液的病例。尽管胸腔腺苷脱氨酶水平升高，但胸膜和左腹股沟淋巴结的手术活检表明积液是由IgG4-RD引起的。由于血清IgG4和胸腔积液自然下降然后完全消失，因此开始了主动监测。该患者4年多来未复发。该病例表明胸膜活检可用于区分IgG4-RD和结核病；此外，一些胸腔积液病例未经治疗也可能改善。
