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We report a case of male IgG4-related Mikulicz’s disease with chronic rhinosinusitis with high serum IgG4-and IgE-Immune Complex (IC). Untreated serum IgG4 was 3,110 mg/dL, while Polyethylene Glycol (PEG)-treated serum IgG4-IC was 1,460mg/dL. Both were markedly elevated (normal IgG4 range <105 mg/dL). Serum IgE and PEG-treated serum IgE-IC was also elevated (normal IgE range <170 IU/mL) at 376 IU/mL and 237 IU/mL, respectively. IgE PEG Precipitated (PP) index was higher than normal (<20%) at 63%. We speculate that serum IgG4 and IgE represented autoantibodies for a component of the paranasal sinus mucosa and submandibular gland tissue.

A Case of IgG4-Related Mikulicz’s Disease with Chronic Rhinosinusitis and Elevated Levels of IgG4-and IgE-Immune Complexes