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

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 gla...

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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:
Case Report
Case studies
Histology
Immunology
Medicine
Medicine & Public Health
Mycobacterium
Orthopedics
Rheumatology
Tuberculosis
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Summary: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:10.1007/s10165-008-0127-z