IgG4-Related Disease Combined with Autoimmune Hemolytic Anemia and Steroid-Responsive Transient Hypercalcemia

A 67-year-old man with elevated serum immunoglobulin G4 (IgG4) levels, systemic lymphadenopathy infiltrated by IgG4-positive plasma cells, and Coombs-positive autoimmune hemolytic anemia (AIHA) showed marked hypercalcemia. Although the intact parathyroid hormone (PTH) level was elevated, 99mTc-MIBI...

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Bibliographic Details
Published inClinical Medicine Insights: Case Reports Vol. 2015; no. 2015; pp. 51 - 55
Main Authors Hasegawa, Sho, Mine, Sohtaro, Hagiwara, Shotaro
Format Journal Article
LanguageEnglish
Published London, England Libertas Academica 01.01.2015
SAGE Publishing
SAGE Publications
Sage Publications Ltd
Subjects
Case Report
parathyroid hormone
autoimmune hemolysis
IgG4-related disease
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Summary:A 67-year-old man with elevated serum immunoglobulin G4 (IgG4) levels, systemic lymphadenopathy infiltrated by IgG4-positive plasma cells, and Coombs-positive autoimmune hemolytic anemia (AIHA) showed marked hypercalcemia. Although the intact parathyroid hormone (PTH) level was elevated, 99mTc-MIBI scintigraphy and thyroid ultrasonography revealed no evidence of primary hyperparathyroidism. Liver biopsy showed marked infiltration of IgG4-positive plasma cells, which confirmed the diagnosis of IgG4-related disease (IgG4-RD). Corticosteroid therapy was initiated, and subsequently, intact PTH and serum calcium levels gradually normalized. Transient hypercalcemia in a patient with AIHA may therefore be associated with IgG4-RD.
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ISSN:1179-5476
1179-5476
DOI:10.4137/CCRep.S25553