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Abstract
Case Report
A case of recurrence of IgG4-related respiratory disease after steroid maintenance treatment for autoimmune pancreatitis
Sachiyo Yamagataa Hirokazu Tokuyasua Natsumi Omura-Tanakaa Hiromitsu Sakaia Soichiro Ishikawaa Akira Yamasakib
aDivision of Respiratory Medicine, Matsue Red Cross Hospital
bDivision of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University
ABSTRACT
A 54-year-old man was diagnosed with autoimmune pancreatitis, and treatment was initiated with 40 mg/day prednisolone. Prednisolone was tapered to 5 mg/day, and the treatment was terminated at 3 years and 2 months from initiation. Thereafter, a dry cough started. Chest computed tomography revealed thickening of the bronchial wall and ground-glass opacification in both lungs, with multiple nodules in the right lower lobe. Elevated serum IgG4 levels were detected, and transbronchial lung biopsy revealed IgG4-related respiratory disease. The administration of 30 mg/day prednisolone relieved the cough and improved the lung manifestations, and prednisolone was reduced gradually. Although rare, the recurrence of IgG4-related respiratory disease can occur after steroid maintenance treatment for autoimmune pancreatitis.
KEYWORDS
IgG4-related respiratory disease (IgG4-RRD) IgG4-related disease (IgG4-RD) Autoimmune pancreatitis (AIP) Prednisolone
Received 14 Sep 2021 ／ Accepted 5 Nov 2021
AJRS, 11(1): 31-36, 2022
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