Synovitis in a Patient with IgG4-related Disease

Intern Med. 2015;54(11):1427-32. doi: 10.2169/internalmedicine.54.4320. Epub 2015 Jun 1.

Abstract

A 71-year-old man was admitted to our department due to arthralgia and renal dysfunction. A physical examination disclosed swelling of the right shoulder and left wrist joints. Laboratory tests showed elevated serum IgG4 and creatinine levels, and magnetic resonance imaging of the wrist revealed bone erosion and synovitis. In addition, fluorodeoxyglucose positron emission tomography showed uptake in the submandibular glands, pancreas, kidneys, and affected joints and a renal biopsy revealed tubulointerstitial nephritis with the infiltration of IgG4+ plasma cells. The patient was subsequently diagnosed with IgG4-related disease (IgG4-RD) and successfully treated with corticosteroid therapy. This case suggests that erosive arthritis may occur in patients with IgG4-RD.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / pathology
  • Biopsy
  • Creatinine / blood
  • Humans
  • Immunoglobulin G / blood*
  • Kidney / pathology
  • Magnetic Resonance Imaging
  • Male
  • Nephritis, Interstitial / complications*
  • Nephritis, Interstitial / pathology
  • Positron-Emission Tomography
  • Shoulder
  • Synovitis / etiology*
  • Wrist

Substances

  • Immunoglobulin G
  • Creatinine