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Igg4 related diseases. A case report in Ecuador and review of the literature

Abstract:

The IgG4-related disease (IgG4-RD) can involve multiple organs, generating fibrous-inflammatory tissue, which causes several clinical manifestations of systemic predominance that can lead to diagnostic confusion. In this case report, we present a 57-year-old male patient, former smoker, with hypertension and with a diagnosis of type II diabetes mellitus; the patient had a left ocular protrusion as initial symptomatology, a thoracotomy was later carried out due to pleural injury, and cholecystectomy as a treatment for the presumed ve-sicular myomatosis observed with an abdominal CT. The histopathological find-ings evidenced a chronic lymphocytic inflammatory response and marked poly-clonal plasmacytosis in multiple organs, with associated fibrosis. Several studies were carried out to discard both a possible autoimmune disease and a suspected monoclonal gammopathy after capillary electrophoresis. Immunohistochemical studies of the affected tissues allowed for the diagnosis of ER-IgG4.