title: Successful treatment of sclerosing mediastinitis with a high serum IgG4 level.
abstract: Sclerosing mediastinitis is not a common condition in the thoracic cavity and is difficult to cure. Several medications have been used; however, most of the cases do not achieve satisfactory results, and the most successful treatment is operative resection. We report the first case of IgG4-related sclerosing mediastinitis that showed IgG4-positive plasma cells infiltrated into the fibrous tissue and a high serum IgG4 level. The patient clearly showed remission of the symptoms after steroid therapy. Our findings suggest that the serum IgG4 level is a good selection indicator for steroid therapy in sclerosing mediastinitis.
authors.affiliation: Department of Chest Surgery, Niigata Rosai Hospital, 1-7-12 Touncho, Joetsu, Niigata, Japan. mainoue@niirou.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inoue
authors.forename: Naohiro
authors.initials: N
authors.lastname: Nose
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawaguchi
mesh_terms: D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008480:Mediastinitis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use*; D012598:Sclerosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D011239:Prednisolone