IgG4-related disease: a new entity sometimes needs a retrospective diagnosis

A 60-year-old male patient presented with a 4-year history of retroperitoneal fibrosis (RF) compressing the aorta, inferior vena cava, left renal vein and left ureter, with ipsilateral renal atrophy. At the time of RF diagnosis, positron emission tomography (PET) scan had shown an expansive retroperitoneal lesion involving large vessels (figure 1). He had also presented a high C-reactive protein (CRP), reduced glomerular filtration rate, polyclonal peak in serum gamma globulins and retroperitoneal biopsy had shown fibrosis and lymphoid infiltration. Figure 1Positron emission tomography scan showing retroperitoneal lesion involving the aorta, with increased glycolytic metabolism (SUV 8.5), extending from the emergence of the celiac artery to the bifurcation of the common iliac arteries, with thickness around 2.5 cm. When first seen in our office, a new CT scan revealed spontaneous regression of fibrosis. Glomerular filtration and CRP were normal. The serum IgG4...
Source: Postgraduate Medical Journal - Category: Journals (General) Authors: Tags: Pancreas and biliary tract, Journalology, Pancreatitis, Immunology (including allergy), Histopathology, Radiology, Surgical diagnostic tests, General surgery, Radiology (diagnostics), Epidemiology, Ethics, Thyroid disease Images in medicine Source Type: research