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

S. Hasegawa | Zendy; Sohtaro Mine | Zendy; Shotaro Hagiwara | Zendy

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

Author(s) -

S. Hasegawa,

Sohtaro Mine,

Shotaro Hagiwara

Publication year - 2015

Publication title -

clinical medicine insights case reports

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.187

H-Index - 12

ISSN - 1179-5476

DOI - 10.4137/ccrep.s25553

Subject(s) - medicine , autoimmune hemolytic anemia , primary hyperparathyroidism , parathyroid hormone , endocrinology , scintigraphy , anemia , biopsy , pathology , calcium

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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