A case of eosinophilic granulomatosis with polyangiitis as a mimicker of IgG4-related disease
A case of eosinophilic granulomatosis with polyangiitis as a mimicker of IgG4-related disease
复制标题
DOI：
10.1080/24725625.2020.1759200
复制
发表时间：
2020-07-02
影响因子：
0.8
通讯作者：
Tanaka, Yoshiya
中科院分区：
文献类型：
--
作者：
Kanda, Ryuichiro;Kubo, Satoshi;Tanaka, Yoshiya
一位62岁的女性因发热、肾功能不全、嗜酸性粒细胞增多症和髓过氧化物酶-抗中性粒细胞胞浆抗体（MPO-ANCA）的存在而入院。肾脏病理检查显示嗜酸性粒细胞肉芽肿病变和新月体肾小球肾炎，诊断为嗜酸性粒细胞肉芽肿病伴多血管炎（EGPA）。另一方面，实验室检查显示血清IgG 4水平升高，肾脏病理检查显示明显的淋巴浆细胞浸润和巢周围纤维化“鸟眼图案”，这是IgG 4相关肾病（IgG 4-RKD）的特征。由于EGPA患者中存在IgG 4-RKD的临床表现，因此对EGPA患者IgG 4-RKD的诊断应慎重。
A 62-year-old woman was admitted to our hospital because of fever, renal dysfunction, eosinophilia, and the presence of MPO-ANCA. Based on the renal pathological examination which showed granuloma lesion with eosinophils and crescentic glomerulonephritis, eosinophilic granulomatosis with polyangiitis (EGPA) was diagnosed. On the other hand, laboratory examination showed elevated serum IgG4 levels and renal pathological examination showed marked lymphoplasmacytic infiltration and fibrosis surrounding nest "Bird's eye pattern," which were characteristic of IgG4-related kidney disease (IgG4-RKD). Because there are cases when EGPA has clinical features of IgG4-RKD, we should be careful about diagnoses of IgG4-RKD in patients with EGPA.