Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan.
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Intern Med. 2023 Jul 15;62(14):2139-2143. doi: 10.2169/internalmedicine.1634-23. Epub 2023 Mar 31.
An 84-year-old woman with IgG4-related disease presented with jaundice and liver dysfunction after coronavirus disease 2019 (COVID-19) vaccination. Serum IgG4 levels were elevated. Diagnostic imaging showed no stenotic lesions in the bile ducts. A liver biopsy was performed because of the enlarged liver. Infiltration of IgG4-positive plasma cells, which accounted for approximately 74% of total plasma cells, was found in the portal area, but there was no evidence of periportal hepatitis, and inflammatory cell infiltration into the lobular space was minimal. IgG4-related hepatopathy was diagnosed. The patient achieved spontaneous remission with no treatment and only follow-up and remains under observation at the time of writing.
一位 84 岁女性，因感染 2019 冠状病毒病（COVID-19）疫苗后出现黄疸和肝功能障碍而就诊。血清 IgG4 水平升高。诊断性影像学检查未发现胆管狭窄病变。由于肝脏肿大，进行了肝活检。在门脉区发现 IgG4 阳性浆细胞浸润，约占总浆细胞的 74%，但无门脉周围肝炎的证据，小叶间炎症细胞浸润很少。诊断为 IgG4 相关肝玻患者未接受治疗，仅通过随访即实现自发缓解，在撰写本文时仍在观察中。
