{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:40:15Z","timestamp":1782931215348,"version":"3.54.5"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>This report describes a patient diagnosed with immunoglobulin G4 (IgG4)-related pancreatitis and kidney disease 7\u2009years after the onset of undiagnosed lymphadenopathy. A 48-year-old Japanese woman presented with fatigue and leg oedema. Computed tomography showed perigastric lymphadenopathy, for which she underwent a laparoscopic biopsy of the perigastric lymph nodes. Although histopathological examination of the lymph nodes did not lead to a definitive diagnosis, serological tests revealed elevated serum IgG4 levels (558\u2009mg\/dl) and IgG4 immunostaining of the lymph nodes showed IgG4-positive plasma cell infiltration, leading to the suspicion of IgG4-related disease. Further workup revealed no organ lesion other than lymphadenopathy. At age 55\u2009years, despite having no subjective symptoms, contrast-enhanced computed tomography showed low-density lesions in the tail of the pancreas and the left kidney. Histopathological examination showed lymphocyte infiltration, consisting of a mixture of plasma cells and eosinophils, in both organs and obliterative phlebitis in the pancreas. IgG4 immunostaining of the kidney specimens showed 160 IgG4-positive cells per high-powered field, with the IgG4+\/IgG+ cell ratio being almost 100%, leading to a diagnosis of IgG4-related pancreatitis and kidney disease. Treatment with prednisolone for 2\u2009months resulted in lesion improvement. Although the diagnosis of IgG4-related lymphadenopathy is often challenging in patients with lymphadenopathy alone, findings in the present patient emphasise the importance of long-term follow-up, as it may allow early detection of involvement of other organs by IgG4-related disease.<\/jats:p>","DOI":"10.1093\/mrcr\/rxac065","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T12:28:26Z","timestamp":1660220906000},"page":"192-196","source":"Crossref","is-referenced-by-count":4,"title":["Development of IgG4-related pancreatitis and kidney disease 7\u2009years after the onset of undiagnosed lymphadenopathy: A case report"],"prefix":"10.1093","volume":"7","author":[{"given":"Misaki","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Kanazawa University Hospital , Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6231-0683","authenticated-orcid":false,"given":"Ichiro","family":"Mizushima","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kanazawa University Hospital , Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Tsuge","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kanazawa University Hospital , Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kanazawa University Hospital , Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Zoshima","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kanazawa University Hospital , Kanazawa, 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