title: A condition closely mimicking IgG4-related disease despite the absence of serum IgG4 elevation and IgG4-positive plasma cell infiltration.
abstract: We describe a 74-year-old Japanese man with systemic fibroinflammatory conditions closely resembling those of immunoglobulin G4-related disease (IgG4-RD). Radiology and histology showed characteristics of IgG4-related tubulointerstitial nephritis, despite normal serum IgG4 value and scanty IgG4-positive plasma cell infiltration in each organ. This case suggests that a condition closely mimicking IgG4-RD may develop without IgG4-positive plasma cells and those exceptional cases should also be taken into account in the differential diagnosis of IgG4-RD.
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.|b Department of Kidney and Vascular Pathology , Graduate School of Comprehensive Human Sciences, University of Tsukuba , Tsukuba, Ibaraki , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hara
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawano
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mizushima
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamada
authors.affiliation: c Department of Respiratory Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Fujita
authors.affiliation: d Department of Human Pathology , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Harada
authors.affiliation: e Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine , Tochigi , Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
authors.affiliation: f Division of Cardiology, Department of Internal Medicine , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.affiliation: g Department of Pathology , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: h Yamaguchi's Pathology Laboratory , Chiba , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: d Department of Human Pathology , Kanazawa University Graduate School of Medicine , Kanazawa, Ishikawa , Japan.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.affiliation: b Department of Kidney and Vascular Pathology , Graduate School of Comprehensive Human Sciences, University of Tsukuba , Tsukuba, Ibaraki , Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Nagata
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D009395:Nephritis, Interstitial / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G
keywords: IgG4; IgG4-related disease; Tubulointerstitial nephritis