A case of immunoglobulin G4-related chronic sclerosing sialadenitis and dacryoadenitis associated with tuberculosis

Abstract We describe a 64-year-old woman with chronic sclerosing sialadenitis and dacryoadenitis, which developed during treatment for cervical lymph node tuberculosis. Anti-tuberculosis treatment did not improve the swelling in the lacrimal and submandibular glands, and a biopsy specimen of the lac...

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Bibliographic Details
Published in:Modern rheumatology 2009-02, Vol.19 (1), p.87-90
Main Authors: Kawano, Mitsuhiro, Yamada, Kazunori, Kakuchi, Yasushi, Ito, Kiyoaki, Hamano, Ryoko, Fujii, Hiroshi, Inoue, Ryo, Matsumura, Masami, Takahira, Masayuki, Zen, Yoh, Yachie, Akihiro, Nakashima, Akikatsu, Yamagishi, Masakazu
Format: Article
Language:English
Subjects:
Antibodies, Bacterial - analysis
Biopsy
Dacryocystitis - complications
Dacryocystitis - diagnosis
Dacryocystitis - metabolism
Diagnosis, Differential
DNA, Bacterial - analysis
Female
Humans
Immunoglobulin G - metabolism
Lacrimal Apparatus - microbiology
Lacrimal Apparatus - pathology
Middle Aged
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - immunology
Mycobacterium tuberculosis - isolation & purification
Sclerosis - pathology
Sialadenitis - complications
Sialadenitis - diagnosis
Sialadenitis - metabolism
Tomography, X-Ray Computed
Tuberculosis, Ocular - complications
Tuberculosis, Ocular - diagnosis
Tuberculosis, Ocular - metabolism
Tuberculosis, Oral - complications
Tuberculosis, Oral - diagnosis
Tuberculosis, Oral - metabolism
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Summary:Abstract We describe a 64-year-old woman with chronic sclerosing sialadenitis and dacryoadenitis, which developed during treatment for cervical lymph node tuberculosis. Anti-tuberculosis treatment did not improve the swelling in the lacrimal and submandibular glands, and a biopsy specimen of the lacrimal gland showed inflammation, with abundant lymphoid follicles with fibrosis and granuloma without caseous necrosis. Immunohistological examination of a repeat biopsy specimen showed abundant immunoglobulin (Ig) G4-positive plasma cell infiltration. Corticosteroid therapy improved the salivary gland swelling without reactivation of the tuberculosis. This case suggests that an abnormal immunological reaction to tuberculosis may be one of the etiological candidates for IgG4-related disease.
ISSN:1439-7595
1439-7609
DOI:10.3109/s10165-008-0127-z