{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:09:33Z","timestamp":1768813773360,"version":"3.49.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>A 65-year-old man presented with apparent bronchopneumonia. After treatment with antibiotics, he showed eosinophilia. Computed tomography (CT) imaging revealed bilateral consolidation, ground-glass opacities with nodular consolidations, and pleural effusion. Lung biopsy showed organising pneumonia with lymphoplasmacytic infiltration in the alveolar septa and in the thickened pleura and interlobular septa. All pulmonary abnormalities spontaneously went into remission within 12\u2009months. At 73\u2009years old, a follow-up CT scan revealed small nodules in both lungs and the review of the head CT scan showed thickening of the pituitary stalk in studying prolonged headache. Two years later, he visited the hospital complaining of severe oedema on the lower extremities with high serum immunoglobulin (Ig)G4 186\u2009mg\/dl. A whole-body CT scan showed retroperitoneal mass surrounding aortic bifurcation and compressing inferior vena cava, pituitary stalk thickening and gland swelling, and enlarged pulmonary nodules. Anterior pituitary stimulation tests showed central hypothyroidism, central hypogonadism, and adult growth hormone deficiency with partial primary hypoadrenocorticism. Retroperitoneal mass biopsy showed storiform fibrosis and obliterative phlebitis with marked lymphoplasmacytic infiltration with moderate IgG4-positivity. Immunostaining of the former lung specimen revealed dense interstitial infiltration of IgG4-positive cells. These findings indicated metachronous development of IgG4-related disease in lung, hypophysis, and retroperitoneum, according to the recent comprehensive diagnostic criteria of IgG4-related disease. Glucocorticoid therapy ameliorated oedema, on the other hand, unmasked partial diabetes insipidus at the initial dose of the treatment. Hypothyroidism and retroperitoneal mass regressed at 6\u2009months of the treatment. This case warns us that long-term follow-up from prodromal to remission is necessary for the treatment of IgG4-related disease.<\/jats:p>","DOI":"10.1093\/mrcr\/rxad040","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T11:05:32Z","timestamp":1688727932000},"page":"163-171","source":"Crossref","is-referenced-by-count":2,"title":["A case of\u00a0immunoglobulin G4\u2013related retroperitoneal fibrosis and\u00a0hypophysitis with antecedent respiratory disease followed by spontaneous remission and\u00a0recurrence"],"prefix":"10.1093","volume":"8","author":[{"given":"Masato","family":"Sakai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Sugita Genpaku Memorial Obama Municipal Hospital , Fukui, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sugita Genpaku Memorial Obama Municipal Hospital , Fukui, 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