Annals of The Japanese Respiratory Society:A possible case of IgG4-positive interstitial pneumonia, with desquamative interstitial pneumonia-like findings evaluated by transbronchial lung cryobiopsy

Abstract

Article in Japanese

Case Report

A possible case of IgG4-positive interstitial pneumonia, with desquamative interstitial pneumonia-like findings evaluated by transbronchial lung cryobiopsy

Keiichiro Takano^a Mamoru Takahashi^a Daiki Nagayama^a Kento Furukawa^a Hiroki Takahashi^b Hirohumi Chiba^a

^aDepartment of Respiratory Medicine and Allergology, Sapporo Medical University
^bDepartment of Rheumatology and Clinical Immunology, Sapporo Medical University

ABSTRACT

This case involves a 73-year-old male, a current smoker, who presented with exertional dyspnea and cough. Chest computed tomography revealed cysts and ground glass opacification predominantly in the peripheral regions of both lower lung lobes. Histopathological examination of the transbronchial lung cryobiopsy suggested desquamative interstitial pneumonia (DIP). However, there was an elevation in serum IgG4 levels, and immunostaining revealed infiltration of IgG4-positive plasma cells. No evidence of obstructive phlebitis or storiform fibrosis was observed. The diagnosis was interstitial pneumonia with DIP-like findings, with infiltration of IgG4-positive cells. Smoking cessation did not lead to improvement, so prednisolone treatment was initiated, resulting in improvement in both radiographic findings and clinical symptoms.

KEYWORDS

Transbronchial lung cryobiopsy (TBLC) IgG4-related respiratory disease (IgG4-RRD) Desquamative interstitial pneumonia (DIP)

Received 25-Mar-24 ／ Accepted 21-May-24

AJRS, 13(5): 237-240, 2024

Search for	AJRS(after 2012) JJRS(before 2011) Both of which
Year	equal after before
Volume	equal after before	Number	equal after before
Title		Author
Abstract		Keywords

Content

Abstract

Case Report

ABSTRACT

KEYWORDS