Geriatric Department, Peking University First Hospital, Xicheng District, Xishiku Avenue No 8, 100034, Beijing, China.
Department of Pathology, Peking University First Hospital, Xicheng District, Xishiku Avenue No 8, 100034, Beijing, China.
BMC Geriatr. 2023 Jan 19;23(1):33. doi: 10.1186/s12877-022-03594-3.
The diagnosis of unilateral eosinophilic pleural effusion (EPE) is difficult, especially for the elderly. IgG4-related disease (IgG4-RD) is a rare cause of EPE.
An 81-year-old man was admitted to the hospital for dyspnea due to right pleural effusion. Laboratory examination shows elevated IgG4 and eosinophils in both serum and pleural fluid. The patient was diagnosed with IgG4-RD by video-assisted thoracoscopy and pleural biopsy. We found no evidence of other organ involvement except for the EPE and history of prurigo. He was treated with prednisolone 40 mg daily orally and pleural effusion decreased significantly.
IgG4-RD should be considered in the differential diagnosis of EPE in the elderly. High effusion IgG4 concentration may be an indication of IgG4-related pleural lesions.
单侧嗜酸性胸腔积液(EPE)的诊断较为困难,尤其是在老年人中。IgG4 相关疾病(IgG4-RD)是 EPE 的一个罕见病因。
一名 81 岁男性因右侧胸腔积液导致呼吸困难而入院。实验室检查显示血清和胸腔积液中 IgG4 和嗜酸性粒细胞升高。患者通过胸腔镜和胸膜活检被诊断为 IgG4-RD。除了 EPE 和瘙痒症病史外,我们未发现其他器官受累的证据。他接受了泼尼松龙 40mg 每日口服治疗,胸腔积液明显减少。
在老年人 EPE 的鉴别诊断中应考虑 IgG4-RD。胸腔积液中 IgG4 浓度升高可能提示与 IgG4 相关的胸膜病变。