Case Report

J Rheum Dis 2015; 22(6): 395-400

Published online December 31, 2015

© Korean College of Rheumatology

Mikulicz’s Disease with Progressively Transformed Germinal Centers-type Immunoglobulin G4-related Lymphadenopathy Mimicking Sj?gren’s Syndrome

Hye Ji Kim1, Jean A Kim2, Jun Ki Min3

1Department of Internal Medicine, The Catholic University of Korea, Catholic Medical Center, Seoul, 2Department of Hospital Pathology, 3Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea, Bucheon St. Mary’s Hospital, Bucheon, Korea

Correspondence to : Jun Ki Min

Received: January 20, 2015; Revised: March 21, 2015; Accepted: March 24, 2015

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disease, and lymphadenopathy is frequently observed in these patients. Among the 5 subtypes of IgG4-related lymphadenopathy, progressively transformed germinal centers (PTGC)-type IgG4-related lymphadenopathy possesses a unique characteristic that differentiates it from the other 4 subtypes. Here, we report on a rare case of PTGC-type IgG4-related lymphadenopathy accompanying Mikulicz’s disease. A 39-year-old female complained of a left cervical mass and bilateral upper eyelid hypertrophy. The serum level of IgG4 was elevated, and computed tomography showed enlargement of the bilateral lacrimal and submandibular glands and left cervical lymph node. Excisional biopsy of a submandibular gland and cervical lymph node was performed, and the histopathologic findings revealed Mikulicz’s disease accompanied by PTGC-type IgG4-related lymphadenopathy. After treatment of the patient with oral prednisolone and azathioprine, the patient’s appearance improved. To the best of our knowledge, no case of PTGC-type IgG4-related lymphadenopathy has been previously reported in Korea. (J Rheum Dis 2015;22:395-400)

Keywords Immunoglobulin G4-related lymphadenopathy, Progressively transformed germinal centers, Immunoglobulin G4-related disease, Mikulicz’s disease

Article

Case Report

J Rheum Dis 2015; 22(6): 395-400

Published online December 31, 2015

Copyright © Korean College of Rheumatology.

Mikulicz’s Disease with Progressively Transformed Germinal Centers-type Immunoglobulin G4-related Lymphadenopathy Mimicking Sj?gren’s Syndrome

Hye Ji Kim1, Jean A Kim2, Jun Ki Min3

1Department of Internal Medicine, The Catholic University of Korea, Catholic Medical Center, Seoul, 2Department of Hospital Pathology, 3Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea, Bucheon St. Mary’s Hospital, Bucheon, Korea

Correspondence to:Jun Ki Min

Received: January 20, 2015; Revised: March 21, 2015; Accepted: March 24, 2015

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disease, and lymphadenopathy is frequently observed in these patients. Among the 5 subtypes of IgG4-related lymphadenopathy, progressively transformed germinal centers (PTGC)-type IgG4-related lymphadenopathy possesses a unique characteristic that differentiates it from the other 4 subtypes. Here, we report on a rare case of PTGC-type IgG4-related lymphadenopathy accompanying Mikulicz’s disease. A 39-year-old female complained of a left cervical mass and bilateral upper eyelid hypertrophy. The serum level of IgG4 was elevated, and computed tomography showed enlargement of the bilateral lacrimal and submandibular glands and left cervical lymph node. Excisional biopsy of a submandibular gland and cervical lymph node was performed, and the histopathologic findings revealed Mikulicz’s disease accompanied by PTGC-type IgG4-related lymphadenopathy. After treatment of the patient with oral prednisolone and azathioprine, the patient’s appearance improved. To the best of our knowledge, no case of PTGC-type IgG4-related lymphadenopathy has been previously reported in Korea. (J Rheum Dis 2015;22:395-400)

Keywords: Immunoglobulin G4-related lymphadenopathy, Progressively transformed germinal centers, Immunoglobulin G4-related disease, Mikulicz’s disease

JRD
Oct 01, 2024 Vol.31 No.4, pp. 191~263
COVER PICTURE
Ancestry-driven pathways for SLE-risk SNP-associated genes. The ancestry-driven key signaling pathways in Asians, Europeans, and African Americans were analyzed by enrichr (https://maayanlab.cloud/Enrichr/#libraries) using non-HLA SNP-associated genes. SLE: systemic lupus erythematosus, SNP: single-nucleotide polymorphism, JAK–STAT: janus kinase–signal transducers and activators of transcription, IFN: interferon gamma. (J Rheum Dis 2024;31:200-211)

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