An Atypical Cystic Renal Mass in a Patient with IgG4-Related Kidney Disease: A Case Report

Chisato Minezaki; Hiroki Uchida; Kouhei Todaka; Nobuchika Koumatsu; Jun Okita; Akiko Kudo; Takeshi Nakata; Akihiro Fukuda; Naoya Fukunaga; Noriko Uesugi; Hirotaka Shibata

doi:10.2169/internalmedicine.4691-24

Chisato Minezaki, Hiroki Uchida, Kouhei Todaka, Nobuchika Koumatsu, Jun Okita, Akiko Kudo, Takeshi Nakata, Akihiro Fukuda, Naoya Fukunaga, Noriko Uesugi, Hirotaka Shibata

Author information

Chisato Minezaki
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Hiroki Uchida
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Kouhei Todaka
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Nobuchika Koumatsu
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Jun Okita
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Akiko Kudo
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Takeshi Nakata
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Akihiro Fukuda
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan
Naoya Fukunaga
Department of Nephrology, Oita Prefectural Hospital, Japan
Noriko Uesugi
Department of Pathology, Fukuoka University of Medicine, Japan
Hirotaka Shibata
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan

Keywords: IgG4, IgG4-related disease, IgG4-related kidney disease, cystic renal mass, tubulointerstitial injury

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4691-24

DOI https://doi.org/10.2169/internalmedicine.4691-24

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Abstract

We herein report a case of IgG4-related kidney disease (IgG4-RKD) with an atypical cystic renal mass in a 73-year-old man. Computed tomography (CT) revealed diffuse renal enlargement and a cystic mass in the left kidney. Blood tests revealed elevated IgG and IgG4 levels. A renal biopsy led to the IgG4-RKD diagnosis. The cystic mass was deemed to be benign based on the clinical, imaging, and ultrasonography findings. No malignancy or abscess formation was noted. Both the renal function and IgG4 levels improved after steroid treatment; moreover, the mass shrunk, suggesting an IgG4-RKD etiology. Cystic renal masses with capsule formation should be considered in patients presenting with IgG4-RKD.

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