{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:08:14Z","timestamp":1753862894069,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>IgG4\u2010related disease is a rare and emerging pathology, characterized by the appearance of pseudotumors. Due to the ability to mimic other pathologies, it is essential to consider it as a differential diagnosis in multisystemic processes. The diagnosis is challenging, requiring a multidisciplinary approach, to minimize the associated morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>IgG4\u2010related disease (IgG4\u2010RD) is a rare, emerging, systemic and chronic pathology, characterized by the appearance of pseudotumors resulting from tissue infiltration by IgG4\u2010positive plasma cells that promote eosinophilic inflammation of the tissue with subsequent fibrosis. We present the case of a male, 45\u2010year\u2010old patient, with marked weight loss and skin pallor detected by his family doctor during a child health consultation of his daughter. When questioned, the patient referred complaints of postprandial discomfort in the left hypochondrium with a feeling of fullness, weight loss, chronic fatigue and hyperhidrosis that had lasted for a month. On physical examination, he was pale, and had pain at palpation of the left hypochondrium. Laboratory data showed increased inflammation markers, abdominal ultrasound and CT demonstrated numerous enlarged lymph nodes in the upper quadrants, raising concern for a malignant lymphoproliferative process. Serological, imaging, clinical and laparoscopic excisional biopsy revealed features of IgG4\u2010related disease and excluded malignant lymphoproliferative disease. The immediate response to treatment with oral prednisolone 30\u2009mg\/day also contributed for diagnosis confirmation. Due to refractory disease after gradual prednisolone reduction, second\u2010line therapy with rituximab was initiated. Over the 6\u2009years of follow\u2010up, the patient presented multiple exacerbations characterized by the emergence of systemic symptoms, being maintained under close clinical and imaging follow\u2010up by reumathology, infectious diseases, and family medicine specialists.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.8894","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T02:02:56Z","timestamp":1715392976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>IgG4\u2010<\/scp>related disease: Case report and 6\u2010year follow\u2010up of an elusive diagnosis mimicking malignancy"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0649-2694","authenticated-orcid":false,"given":"Sara Melo","family":"Oliveira","sequence":"first","affiliation":[{"name":"Family Health Unit of Barrinha, Esmoriz Local Health Unit of the Aveiro Region  Aveiro Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4665-1108","authenticated-orcid":false,"given":"Isabel","family":"Gomes","sequence":"additional","affiliation":[{"name":"Family Health Unit of Barrinha, Esmoriz Local Health Unit of the Aveiro Region  Aveiro Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8442-8749","authenticated-orcid":false,"given":"In\u00eas","family":"Trigo","sequence":"additional","affiliation":[{"name":"Family Health Unit of Barrinha, Esmoriz Local Health Unit of the Aveiro Region  Aveiro Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-769X","authenticated-orcid":false,"given":"Elsa","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Pathology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o; Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade (i3S) and Institute of Molecular Pathology and Immunology University of Porto (Ipatimup); Faculty of Medicine of the University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4525-3717","authenticated-orcid":false,"given":"Rita Neto","family":"Lopes","sequence":"additional","affiliation":[{"name":"Family Health Unit of Barrinha, Esmoriz Local Health Unit of the Aveiro Region  Aveiro Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5568-8045","authenticated-orcid":false,"given":"Ana Sofia","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Family Health Unit of Barrinha, Esmoriz Local Health Unit of the Aveiro Region  Aveiro Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.738540"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1278332"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-021-09215-2"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2023.03.003"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41120"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/572539"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2010.05.003"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39132"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620934911"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-021-04848-w"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-021-02652-2"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1467-x"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/580814"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103083441005"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-010-0317-2"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T05:33:49Z","timestamp":1716960829000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/ccr3.8894"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8894","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2023-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8894"}}