Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
IgG4-Related Pleural Disease Diagnosed by a Re-Evaluation of Chronic Bilateral Pleuritis in a Patient Who Experienced Occasional Acute Left Bacterial Pleuritis
Hiroshi YamamotoToshiro SuzukiMasanori YasuoOrie KobayashiKenji TsushimaMichiko ItoKazuhisa UrushihataYoshitaka YamazakiMasayuki HanaokaTomonobu KoizumiTakeshi UeharaSatoshi KawakamiHideaki HamanoShigeyuki KawaKeishi Kubo
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2011 Volume 50 Issue 8 Pages 893-897


A 78-year-old man with cryptogenic chronic bilateral lymphoplasmacytic pleuritis, diagnosed based on left parietal pleural biopsy specimens obtained by pleuroscopy, developed acute left bacterial pleuritis. The left pleural effusion was neutrophil dominant, however, the right pleural effusion showed lymphoplasmacytic infiltration. Laboratory examinations revealed that his serum IgG4 concentration was increased, with a higher level of IgG4 in the right pleural effusion. Re-evaluation of the previous biopsy specimens using an immunostaining method revealed numerous IgG4-positive plasma cell infiltrations with IgG4-positive/IgG-positive plasma cells at 85.4%. Accordingly, the new diagnosis of this patient was considered to be chronic bilateral IgG4-related pleuritis.

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© 2011 by The Japanese Society of Internal Medicine
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