A case of IgG4-related respiratory disease diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration

DOI
  • Nagao Takayuki
    Department of Respiratory Medicine, Teine Keijinkai Hospital Department of Respiratory Medicine, Municipal Kushiro General Hospital
  • Yokoo Keiki
    Department of Respiratory Medicine, Teine Keijinkai Hospital
  • Sugaya Fumiko
    Department of Respiratory Medicine, Teine Keijinkai Hospital
  • Takenaka Haruka
    Department of Respiratory Medicine, Teine Keijinkai Hospital
  • Sekikawa Motoki
    Department of Respiratory Medicine, Teine Keijinkai Hospital
  • Cammack Ivor
    Department of Clinical Residency, Teine Keijinkai　Hospital
  • Yamada Gen
    Department of Respiratory Medicine, Teine Keijinkai Hospital

Bibliographic Information

Other Title
  • 【投稿/症例報告】後腹膜線維症発症3年後にEBUS-TBNAで診断したIgG4関連呼吸器疾患の1例

Description

A 75-year-old woman was admitted to our hospital with hydronephrosis due to retroperitoneal fibrosis. She was also noted to have high serum levels of IgG4 3 years prior but a clear diagnosis was not made. Steroid therapy did not improve the hydronephrosis, and a ureteral stent was placed. The patient was referred to our department due to cough and subsequent imaging which identified bilateral hilar and mediastinal lymph node enlargement and thickening of the bronchial vascular bundles. Endobronchial ultrasound-guided transbronchial needle aspiration (EBSU-TBNA) of the mediastinal lymph node revealed infiltration of IgG4-positive plasma cells, and she was diagnosed as IgG4-related respiratory disease. On follow up, her cough worsened, and she was initiated on steroid treatment, which improved her condition and reduced the lung lesions. This highlights the need for long-term follow-up of patients with IgG4-related disease.

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