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A Challenging Diagnosis of IgG4-Related Disease When Understanding Limitations of Laboratory Testing Was Pivotal
المؤلفون المشاركون
Ghorab, Z.
Xu, Victoria Y. Y.
Bell, Mary
Zahirieh, Alireza
Hsiao, Janey
Bookman, Arthur
Chan, Pak Cheung
Higgins, Kevin M.
المصدر
العدد
المجلد 2017، العدد 2017 (31 ديسمبر/كانون الأول 2017)، ص ص. 1-5، 5ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2017-07-30
دولة النشر
مصر
عدد الصفحات
5
التخصصات الرئيسية
الملخص EN
A 76-year-old man was incidentally found on a CT scan to have lymphadenopathy and bilateral kidney enlargement suggestive of infiltrative renal disease.
He was largely asymptomatic but had bilateral salivary and lacrimal gland enlargement.
A grossly elevated serum IgG (>70 g/L) with concomitant suppression of other immunoglobulins, a small IgG restriction, and a parotid biopsy revealing lymphoplasmacytic infiltrate with slight kappa light chain excess all suggested a lymphoproliferative disorder (LPD).
The diagnostic workup was further confounded by a normal serum IgG4 concentration.
Moreover, bone marrow and renal biopsies did not reveal evidence of LPD.
Discussion with the laboratory not only clarified that the markedly increased total IgG could not be accounted for by the small IgG restriction, but also identified a discrepancy in the IgG4 measurement.
Repeat analysis of a follow-up sample revealed an elevated IgG4 of 5.94 (reference interval: 0.039–0.864) g/L, which prompted a repeat parotid biopsy that showed predominant IgG4+ lymphocytic infiltrates.
Despite the deluding presentations, a final diagnosis of IgG4-related disease (IgG4-RD) was made based on elevated serum IgG4 concentrations and histopathological findings.
This case highlights the importance of recognizing limitations of laboratory testing and the benefit of close communications among clinical subspecialties and the laboratory.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Xu, Victoria Y. Y.& Bell, Mary& Zahirieh, Alireza& Hsiao, Janey& Higgins, Kevin M.& Ghorab, Z.…[et al.]. 2017. A Challenging Diagnosis of IgG4-Related Disease When Understanding Limitations of Laboratory Testing Was Pivotal. Case Reports in Medicine،Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146886
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Xu, Victoria Y. Y.…[et al.]. A Challenging Diagnosis of IgG4-Related Disease When Understanding Limitations of Laboratory Testing Was Pivotal. Case Reports in Medicine No. 2017 (2017), pp.1-5.
https://search.emarefa.net/detail/BIM-1146886
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Xu, Victoria Y. Y.& Bell, Mary& Zahirieh, Alireza& Hsiao, Janey& Higgins, Kevin M.& Ghorab, Z.…[et al.]. A Challenging Diagnosis of IgG4-Related Disease When Understanding Limitations of Laboratory Testing Was Pivotal. Case Reports in Medicine. 2017. Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146886
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1146886
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر
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