A case of immunoglobulin G4-related chronic sclerosing sialadenitis and dacryoadenitis associated with tuberculosis.
We describe a 64-year-old woman with chronic sclerosing sialadenitis and dacryoadenitis, which developed during treatment for cervical lymph node tuberculosis. Anti-tuberculosis treatment did not improve the swelling in the lacrimal and submandibular glands, and a biopsy specimen of the lacrimal gland showed inflammation, with abundant lymphoid follicles with fibrosis and granuloma without caseous necrosis. Immunohistological examination of a repeat biopsy specimen showed abundant immunoglobulin (Ig) G4-positive plasma cell infiltration. Corticosteroid therapy improved the salivary gland swelling without reactivation of the tuberculosis. This case suggests that an abnormal immunological reaction to tuberculosis may be one of the etiological candidates for IgG4-related disease.
Kawano
Mitsuhiro
M
Division of Rheumatology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, and Saiseikai Kanazawa Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan. mk0920@mac.com
Yamada
Kazunori
K
Kakuchi
Yasushi
Y
Ito
Kiyoaki
K
Hamano
Ryoko
R
Fujii
Hiroshi
H
Inoue
Ryo
R
Matsumura
Masami
M
Takahira
Masayuki
M
Zen
Yoh
Y
Yachie
Akihiro
A
Nakashima
Akikatsu
A
Yamagishi
Masakazu
M
D000907:Antibodies, Bacterial / Q000032:analysis; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis; D003607:Dacryocystitis / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D007765:Lacrimal Apparatus / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D012598:Sclerosis / Q000473:pathology; D012793:Sialadenitis / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D014392:Tuberculosis, Ocular / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D014393:Tuberculosis, Oral / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G