IgG4-related disease (IgG4-RD) is a multi-organ disease characterized by elevated serum IgG4 concentrations, tissue infiltration by IgG4-positive plasma cells, and hypertrophic lesions with fibrosis. Various organs can be involved, including the salivary glands, thyroid, pancreas, bile duct, retroperitoneum, etc.
A 71-year-old man who had received radiation therapy for laryngeal cancer presented to us with swallowing difficulty, dyspnea and anemia. Examination revealed an ulcer in the pharyngeal mucosa, and a biopsy was performed. Based on the histopathological findings, the ulcerative lesions were diagnosed as IgG4-RD. The swallowing difficulty, dyspnea and anemia improved soon after the patient was initiated on prednisolone treatment. A high index of suspicion for IgG4-RD must be held in patients presenting with edematous lesions of the pharynx that are difficult to diagnose.
