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.
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
Mitsuhiro
M
Kawano
Kazunori
K
Yamada
Yasushi
Y
Kakuchi
Kiyoaki
K
Ito
Ryoko
R
Hamano
Hiroshi
H
Fujii
Ryo
R
Inoue
Masami
M
Matsumura
Masayuki
M
Takahira
Yoh
Y
Zen
Akihiro
A
Yachie
Akikatsu
A
Nakashima
Masakazu
M
Yamagishi
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