title: Primary Sjögren's syndrome with chronic tubulointerstitial nephritis and lymphadenopathy mimicking IgG4-related disease.
abstract: We describe a 62-year-old woman with Sjögren's syndrome (SS) presenting with tubulointerstitial nephritis (TIN) and lymphadenopathy mimicking IgG4-related disease (IgG4-RD). Computed tomography revealed multiple swollen lymph nodes. Biopsy of the largest lymph node showed reactive lymphadenopathy with dense IgG4 positive plasma cell (IgG4 + PC) infiltration. Renal biopsy showed chronic plasma cell-rich TIN with IgG4 + PC infiltration. This case suggests that Immunoglobulin G4 immunostaining does not always support the diagnosis of IgG4-RD in the differential diagnosis between SS and IgG4-RD.
authors.affiliation: Division of Rheumatology, Kanazawa University Hospital , Kanazawa, Ishikawa , Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawano
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamada
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mizushima
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaguchi
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology*; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D010950:Plasma Cells / Q000473:pathology; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D007074:Immunoglobulin G
keywords: IgG4; IgG4-related disease; Lymphadenopathy; Sjögren's syndrome; Tubulointerstitial nephritis