Department of Geriatrics, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China.
BMC Geriatr. 2024 Jun 16;24(1):522. doi: 10.1186/s12877-024-05142-7.
IgG4-related diseases are very uncommon, and its diagnosis and treatment are complicated as it encompasses multiple disciplines.
A 77-year-old woman was admitted with a jaw mass and nausea and vomiting. Laboratory tests showed elevated serum IgG4, pituitary MRI suggested thickening of the pituitary stalk, and head and neck CT suggested orbital and mandibular masses. Patients with mandibular mass were diagnosed with Mikulicz's disease with IgG4-related hypophysitis. We found no other evidence of causing thickening of the pituitary stalk. She was given oral prednisolone 30 mg daily, and her nausea and vomiting improved significantly, and the mandibular and ocular masses decreased in size.
Mikulicz's disease combined with IgG4-related hypophysitis is a rare case of IgG4-RD in elderly women. IgG4-RD is one of the causes of head and neck exocrine gland mass and pituitary stalk thickening in the elderly.
IgG4 相关疾病非常罕见，其诊断和治疗涉及多个学科，因此较为复杂。
一名 77 岁女性因颌下肿块伴恶心呕吐入院。实验室检查显示血清 IgG4 升高，垂体 MRI 提示垂体柄增粗，头颈部 CT 提示眼眶和下颌肿块。下颌肿块患者被诊断为 IgG4 相关垂体炎的 Mikulicz 病。我们未发现其他导致垂体柄增粗的证据。给予患者泼尼松龙 30mg/d 口服，其恶心呕吐明显改善，颌下和眼部肿块缩小。
Mikulicz 病合并 IgG4 相关垂体炎是老年女性 IgG4-RD 的罕见病例。IgG4-RD 是导致老年患者头颈部外分泌腺体肿块和垂体柄增粗的原因之一。
