Mikulicz's disease combined with IgG4-related hypophysitis: a case report

• Published in: BMC geriatrics Vol. 24; no. 1; pp. 522 - 5
• Main Authors: Zhang, Shu-Fan, Deng, Jing, Xiao, Jie, Wu, Bi-Hua
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.06.2024; BioMed Central; BMC
• Subjects: Aged; Aged patients; Analysis; Antigens; Autoimmune Hypophysitis - complications; Autoimmune Hypophysitis - drug therapy; Care and treatment; Case Report; Case reports; Complications and side effects; CT imaging; Disease; Exocrine glands; Eye diseases; Female; Gender; Genetic aspects; Head and neck; Health aspects; Histopathology; Humans; IgG4-related disease; IgG4-related hypophysitis; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin G4-Related Disease - complications; Immunoglobulin G4-Related Disease - diagnosis; Immunoglobulin G4-Related Disease - drug therapy; Inflammation; Jaw; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Mandible; Measurement; Mikulicz' Disease - complications; Mikulicz' Disease - diagnosis; Mikulicz' Disease - drug therapy; Mikulicz’s disease; Nausea; Older people; Patients; Pituitary; Pituitary diseases; Pituitary gland; Pituitary stalk; Plasma; Prednisolone; Prednisolone - administration & dosage; Prednisolone - therapeutic use; Rheumatism; Rheumatology; Serology; Tumors; Vomiting; China; Case report; Pituitary stalk; IgG4-related disease; IgG4-related hypophysitis; Mikulicz’s disease
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-024-05142-7

IgG4-related diseases are very uncommon, and its diagnosis and treatment are complicated as it encompasses multiple disciplines. A 77-year-old woman was admitted with a jaw mass and nausea and vomiting. Laboratory tests showed elevated serum IgG4, pituitary MRI suggested thickening of the pituitary stalk, and head and neck CT suggested orbital and mandibular masses. Patients with mandibular mass were diagnosed with Mikulicz's disease with IgG4-related hypophysitis. We found no other evidence of causing thickening of the pituitary stalk. She was given oral prednisolone 30 mg daily, and her nausea and vomiting improved significantly, and the mandibular and ocular masses decreased in size. Mikulicz's disease combined with IgG4-related hypophysitis is a rare case of IgG4-RD in elderly women. IgG4-RD is one of the causes of head and neck exocrine gland mass and pituitary stalk thickening in the elderly.