Dentistry, AIIMS Mangalagiri, Mangalagiri, Andhra Pradesh, India
Pathology, AIIMS Mangalagiri, Mangalagiri, Andhra Pradesh, India.
BMJ Case Rep. 2024 Jul 1;17(7):e260749. doi: 10.1136/bcr-2024-260749.
A woman in her 30s presented with a 12-month history of reduced mouth opening and swelling on the right side of her mandible. The swelling was non-tender and firm on palpation. The swelling began to increase in size after the extraction of her carious wisdom tooth. Histopathological and serological examinations confirmed the diagnosis of IgG4-related disease, manifested as a mass in the mandible. The patient was prescribed oral corticosteroids at a tapering dosage over 8 weeks. After 3 months, there was an improvement in the patient's mouth opening and a reduction in the size of the swelling. The patient remains in follow-up care. Including IgG4-related disease in the list of potential diagnoses for oral soft tissue masses is crucial, given their positive response to medical treatment, highlighting the significance of an accurate diagnosis to prevent unnecessary surgery, with oral lesions potentially serving as early indicators before multiorgan complications arise.
一位 30 多岁的女性患者因张口受限和下颌右侧肿胀就诊，病史 12 个月。肿胀触诊时无触痛，质地坚硬。肿胀在拔除龋齿智齿后开始增大。组织病理学和血清学检查证实了 IgG4 相关疾病的诊断，表现为下颌骨肿块。患者接受了为期 8 周的逐渐减量的口服皮质类固醇治疗。治疗 3 个月后，患者张口度改善，肿胀缩小。患者仍在随访中。鉴于 IgG4 相关疾病对药物治疗有良好的反应，将其纳入口腔软组织肿块的潜在诊断清单至关重要，这突出了准确诊断的重要性，以防止不必要的手术，口腔病变可能是多器官并发症出现前的早期指标。
