title: Elevated Serum IgG4 Complicated by Pericardial Involvement with a Patchy (18)F-FDG Uptake in PET/CT: Atypical Presentation of IgG4-related Disease.
abstract: IgG4-related pericardial involvement has rarely been reported and its clinical features remain unknown. We herein report a case of a 50-year-old woman with pericarditis who presented with a fever, elevated C-reactive protein levels, elevated serum IgG4 concentrations, and thickened pericardium with a patchy (18)F-fluorodeoxyglucose (FDG) uptake. A biopsy specimen of (18)F-FDG accumulated in the mediastinal lymph nodes revealed an abundant infiltration of IgG4-bearing plasma cells without fibrosis. Moderate-dose glucocorticoids promptly resolved the physical, serological, and imaging abnormalities, thus indicating a relatively acute and reversible nature of IgG4-related pericardial involvement.
authors.affiliation: Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Matsumiya
authors.forename: Osamu
authors.initials: O
authors.lastname: Hosono
authors.forename: Noritada
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uehara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Aya
authors.initials: A
authors.lastname: Oda
authors.forename: Erika
authors.initials: E
authors.lastname: Matsubara
authors.forename: Shuji
authors.initials: S
authors.lastname: Tanada
authors.forename: Yukako
authors.initials: Y
authors.lastname: Shintani
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagayama
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005334:Fever / Q000209:etiology; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage / Q000378:metabolism*; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008198:Lymph Nodes / Q000276:immunology / Q000378:metabolism*; D008482:Mediastinum; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D010493:Pericarditis / Q000150:complications / Q000000981:diagnostic imaging / Q000276:immunology / Q000378:metabolism*; D010496:Pericardium / Q000378:metabolism*; D010950:Plasma Cells / Q000276:immunology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein