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Published in: BMC Geriatrics 1/2023

Open Access 01-12-2023 | Dyspnea | Case report

IgG4-related eosinophilic pleural effusion: a case report

Authors: Lina Wang, Jiting Di, Junfang Huang, Cuiyan Guo

Published in: BMC Geriatrics | Issue 1/2023

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Abstract

Background

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.

Case presentation

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.

Conclusion

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.
Literature
1.
go back to reference Jany B, Welte T. Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int. 2019;116:377–86. Jany B, Welte T. Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int. 2019;116:377–86.
2.
3.
go back to reference Oba Y, Abu-Salah T. The prevalence and diagnostic significance of eosinophilic pleural effusions: a meta-analysis and systematic review. Respiration. 2012;83:198–208.CrossRef Oba Y, Abu-Salah T. The prevalence and diagnostic significance of eosinophilic pleural effusions: a meta-analysis and systematic review. Respiration. 2012;83:198–208.CrossRef
4.
go back to reference Kalomenidis I, Light RW. Pathogenesis of the eosinophilic pleural effusions. Curr Opin Pulm Med. 2004;10:289–93.CrossRef Kalomenidis I, Light RW. Pathogenesis of the eosinophilic pleural effusions. Curr Opin Pulm Med. 2004;10:289–93.CrossRef
5.
go back to reference Adelman M, Albelda SM, Gottlieb J, et al. Diagnostic utility of pleural fluid eosinophilia. Am J Med. 1984;77:915–20.CrossRef Adelman M, Albelda SM, Gottlieb J, et al. Diagnostic utility of pleural fluid eosinophilia. Am J Med. 1984;77:915–20.CrossRef
6.
go back to reference Kasashima S, Kawashima A, Ozaki S, et al. Clinicopathological features of immunoglobulin G4-related pleural lesions and diagnostic utility of pleural effusion cytology. Cytopathology. 2019;30:285–94.CrossRef Kasashima S, Kawashima A, Ozaki S, et al. Clinicopathological features of immunoglobulin G4-related pleural lesions and diagnostic utility of pleural effusion cytology. Cytopathology. 2019;30:285–94.CrossRef
7.
go back to reference Kamisawa T, Zen Y, Pillai S, et al. IgG4-related disease. Lancet. 2015;385:1460–71.CrossRef Kamisawa T, Zen Y, Pillai S, et al. IgG4-related disease. Lancet. 2015;385:1460–71.CrossRef
8.
go back to reference Wallace ZS, Deshpande V, Mattoo H, et al. IgG4-Related Disease: Clinical and Laboratory Features in One Hundred Twenty-Five Patients. Arthritis Rheumatol. 2015;67:2466–75.CrossRef Wallace ZS, Deshpande V, Mattoo H, et al. IgG4-Related Disease: Clinical and Laboratory Features in One Hundred Twenty-Five Patients. Arthritis Rheumatol. 2015;67:2466–75.CrossRef
9.
go back to reference Fei Y, Shi J, Lin W, et al. Intrathoracic Involvements of Immunoglobulin G4-Related Sclerosing Disease. Med (Baltim). 2015;94:e2150.CrossRef Fei Y, Shi J, Lin W, et al. Intrathoracic Involvements of Immunoglobulin G4-Related Sclerosing Disease. Med (Baltim). 2015;94:e2150.CrossRef
10.
go back to reference Kasashima S, Kawashima A, Zen Y, et al. Upregulated interleukins (IL-6, IL-10, and IL-13) in immunoglobulin G4-related aortic aneurysm patients. J Vasc Surg. 2018;67:1248–62.CrossRef Kasashima S, Kawashima A, Zen Y, et al. Upregulated interleukins (IL-6, IL-10, and IL-13) in immunoglobulin G4-related aortic aneurysm patients. J Vasc Surg. 2018;67:1248–62.CrossRef
11.
go back to reference Zhang X, Zhang P, Li J, et al. Different clinical patterns of IgG4-RD patients with and without eosinophilia. Sci Rep. 2019;9:16483.CrossRef Zhang X, Zhang P, Li J, et al. Different clinical patterns of IgG4-RD patients with and without eosinophilia. Sci Rep. 2019;9:16483.CrossRef
12.
go back to reference Kamisawa T, Zen Y, Pillai S, et al. IgG4-related disease. Lancet. 2015;385:1460–71.CrossRef Kamisawa T, Zen Y, Pillai S, et al. IgG4-related disease. Lancet. 2015;385:1460–71.CrossRef
13.
go back to reference Krenke R, Nasilowski J, Korczynski P, et al. Incidence and aetiology of eosinophilic pleural effusion. Eur Respir J. 2009;34:1111–17.CrossRef Krenke R, Nasilowski J, Korczynski P, et al. Incidence and aetiology of eosinophilic pleural effusion. Eur Respir J. 2009;34:1111–17.CrossRef
14.
go back to reference Saito Z, Yoshida M, Kojima A, et al. Characteristics of pleural effusion in IgG4-related pleuritis. Respir Med Case Rep. 2020;29:101019. Saito Z, Yoshida M, Kojima A, et al. Characteristics of pleural effusion in IgG4-related pleuritis. Respir Med Case Rep. 2020;29:101019.
15.
go back to reference Deshpande V, Zen Y, Chan JK, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol. 2012;25:1181–92.CrossRef Deshpande V, Zen Y, Chan JK, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol. 2012;25:1181–92.CrossRef
16.
go back to reference Murata Y, Aoe K, Mimura Y. Pleural effusion related to IgG4. Curr Opin Pulm Med. 2019;25:384–90.CrossRef Murata Y, Aoe K, Mimura Y. Pleural effusion related to IgG4. Curr Opin Pulm Med. 2019;25:384–90.CrossRef
17.
go back to reference Murata Y, Aoe K, Mimura-Kimura Y, et al. Association of immunoglobulin G4 and free light chain with idiopathic pleural effusion. Clin Exp Immunol. 2017;190:133–42.CrossRef Murata Y, Aoe K, Mimura-Kimura Y, et al. Association of immunoglobulin G4 and free light chain with idiopathic pleural effusion. Clin Exp Immunol. 2017;190:133–42.CrossRef
Metadata
Title
IgG4-related eosinophilic pleural effusion: a case report
Authors
Lina Wang
Jiting Di
Junfang Huang
Cuiyan Guo
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03594-3

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