Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review

Background: Immunoglobulin G4-related disease (IgG4-RD), a rare immune-mediated disease affecting multiple organs, rarely involves the pleura. This study presents a case of pleural IgG4-RD and reviews the literature to elucidate the patient population, manifestations, and diagnostic and treatment ch...

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Main Authors: Liying Zhang, Li Mo
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Experimental Gerontology
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Online Access:http://www.sciencedirect.com/science/article/pii/S053155652500035X
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author Liying Zhang
Li Mo
author_facet Liying Zhang
Li Mo
author_sort Liying Zhang
collection DOAJ
description Background: Immunoglobulin G4-related disease (IgG4-RD), a rare immune-mediated disease affecting multiple organs, rarely involves the pleura. This study presents a case of pleural IgG4-RD and reviews the literature to elucidate the patient population, manifestations, and diagnostic and treatment characteristics of pleural IgG4-RD. This study aimed to expand the existing case database of pleural IgG4-RD and enhance the understanding and management of this rare disease. Methods: We report a case of IgG4-RD involving the pleura in an 80-year-old woman with a weight of 62 kg and a body mass index (BMI) of 23.2 kg/m2. Additionally, we reviewed pleural biopsy-confirmed IgG4-RD cases in the PubMed, Scopus, Web of Science, Embase, and Science Direct databases. Results: Forty-one patients with IgG4-RD confirmed by pleural biopsy were included. The median age was 69 years, with male predominance (31, 75.6 %). The most common manifestations were pleural effusion (37, 90.2 %) and dyspnea (26, 63.4 %). Elevated serum IgG4 levels were observed in 38 patients (92.7 %), with a median value of 398.2 mg/dL. Twenty-six patients met two histological criteria for IgG4-RD. Thirty-seven patients received glucocorticoid therapy, 34 of whom achieved clinical improvement. Conclusions: IgG4-RD with pleural involvement mainly manifests as pleural effusion and dyspnea, responding to glucocorticoid therapy. The possibility of this disease should be considered in patients with pleural effusion and enlargement of tissues or organs. Medical staff should attach importance to the application of the Comprehensive Geriatric Assessment (CGA) and the Geriatric Interdisciplinary Team (GIT) in the disease management of older patients.
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spelling doaj-art-1b3fb106f1cd439e80457cf7a4156f162025-02-12T05:30:29ZengElsevierExperimental Gerontology1873-68152025-03-01201112707Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature reviewLiying Zhang0Li Mo1Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, ChinaCorresponding author at: Postal code: 610041, China.; Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, ChinaBackground: Immunoglobulin G4-related disease (IgG4-RD), a rare immune-mediated disease affecting multiple organs, rarely involves the pleura. This study presents a case of pleural IgG4-RD and reviews the literature to elucidate the patient population, manifestations, and diagnostic and treatment characteristics of pleural IgG4-RD. This study aimed to expand the existing case database of pleural IgG4-RD and enhance the understanding and management of this rare disease. Methods: We report a case of IgG4-RD involving the pleura in an 80-year-old woman with a weight of 62 kg and a body mass index (BMI) of 23.2 kg/m2. Additionally, we reviewed pleural biopsy-confirmed IgG4-RD cases in the PubMed, Scopus, Web of Science, Embase, and Science Direct databases. Results: Forty-one patients with IgG4-RD confirmed by pleural biopsy were included. The median age was 69 years, with male predominance (31, 75.6 %). The most common manifestations were pleural effusion (37, 90.2 %) and dyspnea (26, 63.4 %). Elevated serum IgG4 levels were observed in 38 patients (92.7 %), with a median value of 398.2 mg/dL. Twenty-six patients met two histological criteria for IgG4-RD. Thirty-seven patients received glucocorticoid therapy, 34 of whom achieved clinical improvement. Conclusions: IgG4-RD with pleural involvement mainly manifests as pleural effusion and dyspnea, responding to glucocorticoid therapy. The possibility of this disease should be considered in patients with pleural effusion and enlargement of tissues or organs. Medical staff should attach importance to the application of the Comprehensive Geriatric Assessment (CGA) and the Geriatric Interdisciplinary Team (GIT) in the disease management of older patients.http://www.sciencedirect.com/science/article/pii/S053155652500035XImmunoglobulin G4-related diseasePleuraOlder adultsDiagnosisCase report
spellingShingle Liying Zhang
Li Mo
Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
Experimental Gerontology
Immunoglobulin G4-related disease
Pleura
Older adults
Diagnosis
Case report
title Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
title_full Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
title_fullStr Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
title_full_unstemmed Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
title_short Immunoglobulin G4-related disease with pleural involvement in an 80-year-old female patient: A case report and literature review
title_sort immunoglobulin g4 related disease with pleural involvement in an 80 year old female patient a case report and literature review
topic Immunoglobulin G4-related disease
Pleura
Older adults
Diagnosis
Case report
url http://www.sciencedirect.com/science/article/pii/S053155652500035X
work_keys_str_mv AT liyingzhang immunoglobuling4relateddiseasewithpleuralinvolvementinan80yearoldfemalepatientacasereportandliteraturereview
AT limo immunoglobuling4relateddiseasewithpleuralinvolvementinan80yearoldfemalepatientacasereportandliteraturereview