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Immunoglobulin G4-related constrictive pericarditis identified by cytological examination of pericardial effusion: a case report.
- Source :
- Journal of Medical Case Reports; 12/20/2016, Vol. 10, p1-5, 5p
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Immunoglobulin G4-related disease is increasingly recognized as a systemic autoimmune disorder characterized by immunoglobulin G4-positive lymphocyte infiltration. Organ biopsy and histopathology are the most important diagnostic methods; however, the significance of a cytological examination in immunoglobulin G4-related disease cases is still unclear.<bold>Case Presentation: </bold>A 73-year-old Asian man who was a former tobacco smoker presented with progressive exertional dyspnea, systemic edema, and pericardial effusion. A cytological examination of his pericardial effusion detected three or four plasma cells per high-power field by Giemsa staining. Moreover, immunoglobulin G4-positive plasma cells were detected by immunostaining. Cardiac catheterization after pericardiocentesis revealed that both ventricular pressure traces showed an early diastolic dip and plateau. Positron-emission tomography with 18F-fluorodeoxyglucose imaging revealed inflammatory foci in his pericardium. A surgical pericardiectomy was performed and the resultant specimen showed significant immunoglobulin G4-positive plasma cell infiltration and marked fibrous thickening of his pericardium; therefore, a diagnosis of constrictive pericarditis due to immunoglobulin G4-related disease was made. Oral administration of 0.6-mg/kg/day prednisolone resolved his heart failure and he was discharged on foot 1 week later.<bold>Conclusion: </bold>Our experience with this case indicates that cytological examination of pericardial effusion was useful in the diagnosis of immunoglobulin G4-related disease. [ABSTRACT FROM AUTHOR]
- Subjects :
- IMMUNOGLOBULIN G
POSITRON emission tomography
CYTOLOGY
FLUORODEOXYGLUCOSE F18
ADRENOCORTICAL hormones
HORMONE therapy
ANTI-inflammatory agents
PREDNISOLONE
DYSPNEA
CARDIAC surgery
IMMUNOGLOBULINS
PERICARDITIS
PERICARDIUM paracentesis
TREATMENT effectiveness
DISEASE progression
DISEASE complications
PERICARDIAL effusion
DIAGNOSIS
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 17521947
- Volume :
- 10
- Database :
- Complementary Index
- Journal :
- Journal of Medical Case Reports
- Publication Type :
- Academic Journal
- Accession number :
- 120368983
- Full Text :
- https://doi.org/10.1186/s13256-016-1159-1