IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion

Atsushi Nagayasu; Satoshi Kubo; Kazuhisa Nakano; Shingo Nakayamada; Shigeru Iwata; Ippei Miyagawa; Shunsuke Fukuyo; Kazuyoshi Saito; Yoshiya Tanaka

doi:10.2169/internalmedicine.0387-17

CASE REPORTS

IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion

Atsushi Nagayasu, Satoshi Kubo, Kazuhisa Nakano, Shingo Nakayamada, Shigeru Iwata, Ippei Miyagawa, Shunsuke Fukuyo, Kazuyoshi Saito, Yoshiya Tanaka

著者情報

Atsushi Nagayasu
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Satoshi Kubo
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Kazuhisa Nakano
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Shingo Nakayamada
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Shigeru Iwata
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Ippei Miyagawa
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Shunsuke Fukuyo
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
Kazuyoshi Saito
Internal Medicine, Tobata General Hospital, Japan
Yoshiya Tanaka
The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan

キーワード: IgG4-related disease with pleuritis, pleural effusion, adenosine deaminase, tuberculous pleurisy, pleural biopsy

ジャーナルオープンアクセス

2018 年 57 巻 15 号 p. 2251-2257

DOI https://doi.org/10.2169/internalmedicine.0387-17

Browse “Advance online publication” version

詳細

抄録

An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pleural effusion. A surgical pleural biopsy revealed that there were large numbers of IgG4-positive cells and IgG4/IgG positive cell ratio exceeded 40% in several sites. Accordingly, we diagnosed IgG4-related pleuritis and treated with the patient with glucocorticoid therapy. The ADA levels in pleural effusion can increase in IgG4-related pleuritis, and it is therefore important to perform a pleural biopsy.

責任著者(Corresponding author)

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