免疫球蛋白G4相关疾病(IgG4-RD)是已知影响多器官系统的全身性病症。虽然它的表现多种多样,肺部受累,尤其是胸膜,仍然不太常见。我们报告了一名99岁的沙特男性,有糖尿病病史,慢性肾病,和高血压。他出现呼吸困难和晕厥,放射学检查结果显示胸腔积液和右半膈肿块。实验室调查强调血清IgG4水平升高,组织病理学评估证实了IgG4-RD的诊断。值得注意的是,患者的胸部组织病理学不同于典型的IgG4-RD表现,强调疾病的变异性。该病例强调了将IgG4-RD识别为无法解释的胸腔积液的潜在原因的重要性。它还强调需要全面的诊断方法,整合实验室值,组织病理学发现,和临床背景。鉴于胸部IgG4-RD组织病理学的潜在变异性,临床医生应提高对这种情况的认识,以避免漏诊.
Immunoglobulin G4-related disease (IgG4-RD) is a systemic condition known to affect multiple organ systems. While its manifestations are diverse, pulmonary involvement, especially of the pleura, remains less common. We report the case of a 99-year-old Saudi male with a medical history of diabetes mellitus, chronic kidney disease, and hypertension. He presented with dyspnea and syncope, with radiological findings revealing pleural effusion and a mass in the right hemidiaphragm. Laboratory investigations highlighted elevated serum IgG4 levels, and histopathological evaluation confirmed the diagnosis of IgG4-RD. Notably, the patient\'s thoracic histopathology differed from typical IgG4-RD presentations, emphasizing the variability of the disease. This case underscores the significance of recognizing IgG4-RD as a potential cause of unexplained pleural effusion. It also highlights the need for a comprehensive diagnostic approach, integrating laboratory values, histopathological findings, and clinical context. Given the potential variability in thoracic IgG4-RD histopathology, clinicians should maintain a heightened awareness of this condition to avoid missed diagnoses.