title: Elevated serum IgG4 levels in two cases of paragonimiasis.
abstract: Paragonimiasis is a parasitic pleuropulmonary infection caused by eating raw crustaceans and wild boar meat and this infection is endemic in Asia. We herein report two cases of pulmonary P aragonimus westermani infection associated with elevated levels of serum immunoglobulin (Ig) G4 and dense infiltration of IgG4-positive plasma cells in the lung lesions. Treatment with praziquantel resolved the pulmonary lesions and decreased the serum levels of IgG4. IgG4-related disease is a systemic disease occasionally involving the lungs and leads to increased serum levels of IgG4. Our findings suggest that P. westermani infection requires a differential diagnosis from IgG4-related diseases and the serum IgG4 level may be a potentially useful marker of P. westermani infection.
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Saeki
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Horio
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Hirosako
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ichiyasu
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital Kumamoto, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kohrogi
keywords: IgG4; IgG4-related disease; Paragonimus westermani; paragonimiasis; parasitic infection