title: IgG4-Related Sialoadenitis with a Skin Lesion and Multiple Mononeuropathies Suggesting Coexistent Cryoglobulinemic Vasculitis.
abstract: A 68-year-old man was admitted because of weakness of the left leg, dysesthesiae of the extremities and bilateral lower extremity purpura. A neurological examination showed mononeuritis multiplex with laboratory evidence of hypocomplementemia, cryoglobulinemia and leukocytoclastic vasculitis in the biopsy of a skin specimen. The patient also exhibited bilateral submandibular gland swelling, elevated serum IgG4 levels and infiltration of a large number of IgG4-positive plasma cells in the submandibular glands. These findings were consistent with both cryoglobulinemic vasculitis and IgG4-related disease. The administration of oral prednisolone (1 mg/kg/day) resolved the neurological manifestations and the swelling of the submandibular glands and cryoglobulinemia.
authors.affiliation: Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kamiya
authors.forename: Peter Y
authors.initials: PY
authors.lastname: Shane
authors.forename: Makoto
authors.initials: M
authors.lastname: Soejima
authors.forename: Shuji
authors.initials: S
authors.lastname: Tohda
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyasaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kohsaka
mesh_terms: D000368:Aged; D003449:Cryoglobulinemia / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D020422:Mononeuropathies / Q000150:complications*; D010950:Plasma Cells / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D012793:Sialadenitis / Q000150:complications*; D013363:Submandibular Gland / Q000473:pathology; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy; D018366:Vasculitis, Leukocytoclastic, Cutaneous
chemical_list: D007074:Immunoglobulin G; D011239:Prednisolone