Ancy Elsa Thomas, Balamugesh Thangakunam, Thomas Kodiatte, Devasahayam Jesudas Christopher
{"title":"IgG4 Related Disease Presenting With Eosinophilic Pleural Effusion.","authors":"Ancy Elsa Thomas, Balamugesh Thangakunam, Thomas Kodiatte, Devasahayam Jesudas Christopher","doi":"10.1002/rcr2.70111","DOIUrl":null,"url":null,"abstract":"<p><p>A 56-year-old man presented with right-sided pleuritic chest pain and intermittent cough for 4 months, with a background history of well-controlled asthma and allergic rhinitis. Chest radiographs revealed right-sided pleural effusion, the fluid chemistry showed an exudate effusion with negative cytology and abundant eosinophils. Thoracoscopic pleural biopsy showed moderate lymphoplasmacytic chronic inflammation. Immunohistochemistry showed IgG4 staining up to 90 plasma cells/hpf (> 10% diagnostic), and the IgG4: IgG ratio was 40% (> 40% diagnostic), confirming the diagnosis of IgG4-related disease (IgG4-RD). Elevated serum IgG4 level (300 mg/dL; normal range: 3-201 mg/dL), further supported the diagnosis. While eosinophilic pleural effusion (EPE) accounts for 5%-16% of all exudative pleural effusions, IgG4-related pleural disease is an extremely rare cause of EPE.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 2","pages":"e70111"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829249/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/rcr2.70111","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
IgG4 Related Disease Presenting With Eosinophilic Pleural Effusion.
A 56-year-old man presented with right-sided pleuritic chest pain and intermittent cough for 4 months, with a background history of well-controlled asthma and allergic rhinitis. Chest radiographs revealed right-sided pleural effusion, the fluid chemistry showed an exudate effusion with negative cytology and abundant eosinophils. Thoracoscopic pleural biopsy showed moderate lymphoplasmacytic chronic inflammation. Immunohistochemistry showed IgG4 staining up to 90 plasma cells/hpf (> 10% diagnostic), and the IgG4: IgG ratio was 40% (> 40% diagnostic), confirming the diagnosis of IgG4-related disease (IgG4-RD). Elevated serum IgG4 level (300 mg/dL; normal range: 3-201 mg/dL), further supported the diagnosis. While eosinophilic pleural effusion (EPE) accounts for 5%-16% of all exudative pleural effusions, IgG4-related pleural disease is an extremely rare cause of EPE.
期刊介绍：
Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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