{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:34:37Z","timestamp":1792712077655,"version":"4.5.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"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":[[2024,7,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Immunoglobulin (Ig) G4\u2013related disease (IgG4-RD) is a systemic inflammatory disease characterised by elevated serum IgG4, IgG4+ cell infiltration, storiform fibrosis, and obliterative phlebitis. While IgG4-RD can affect various organs, gastrointestinal tract involvement is less common. Here, we report a 70-year-old female with IgG4-RD complicated with diffuse and chronic gastrointestinal inflammation, which led to small intestinal perforation. She had been suffering from anorexia, abdominal pain, vomiting, and diarrhoea and hospitalised due to recurrent ileus. Consequently, she was referred due to small intestinal perforation required for surgical intervention. Pathology revealed acute and chronic inflammation with massive IgG4+ plasmacyte infiltration into mucosa of the small intestine and ischaemic change secondarily caused by chronic inflammation. Random biopsies from the mucosa of stomach, duodenum, ileum, and colon also revealed diffuse and massive IgG4+ plasmacyte infiltration in stomach, duodenum, small intestine, and colon. She was diagnosed with IgG4-RD based on the pathological findings and elevated serum IgG4 levels. Glucocorticoid rapidly ameliorated the symptoms. IgG4-RD may cause gastrointestinal manifestations, and histopathological assessment should be considered, even in the absence of specific characteristics of IgG4-RD.<\/jats:p>","DOI":"10.1093\/mrcr\/rxae012","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T18:29:09Z","timestamp":1711650549000},"page":"323-328","source":"Crossref","is-referenced-by-count":6,"title":["IgG4-related disease complicated with diffuse and chronic gastrointestinal inflammation leading to small intestinal perforation"],"prefix":"10.1093","volume":"8","author":[{"given":"Kazuma","family":"Ino","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Arinuma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Akiya","sequence":"additional","affiliation":[{"name":"Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Kajita","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sosei","family":"Okina","sequence":"additional","affiliation":[{"name":"Department of Hematology, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Ageo Central General Hospital , Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Matsueda","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuhiko","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumiaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Oku","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-9435","authenticated-orcid":false,"given":"Kunihiro","family":"Yamaoka","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"2024083002025763900_R1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1056\/NEJMra1104650","article-title":"IgG4-related disease","volume":"366","author":"Stone","year":"2012","journal-title":"N Engl J 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disease: a gastric mass, associated with regional lymphadenopathy","volume":"16","author":"Bulanov","year":"2016","journal-title":"BMC Surg"},{"key":"2024083002025763900_R6","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1159\/000501513","article-title":"Immunoglobulin G4-related disease manifesting as isolated, typical, and nontypical gastroesophageal lesion: a research of literature review","volume":"101","author":"Khan","year":"2020","journal-title":"Digestion"},{"key":"2024083002025763900_R7","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1007\/s12328-020-01337-8","article-title":"IgG4-related disease manifesting as symptoms of appendicitis: case report and literature review","volume":"14","author":"Cabrales-Escobar","year":"2021","journal-title":"Clin J Gastroenterol"},{"key":"2024083002025763900_R8","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1097\/PAS.0b013e3182495c96","article-title":"IgG4-related sclerosing disease of the small bowel presenting as necrotizing mesenteric arteritis and a solitary jejunal ulcer","volume":"36","author":"Wong","year":"2012","journal-title":"Am J Surg Pathol"},{"key":"2024083002025763900_R9","doi-asserted-by":"crossref","first-page":"776","DOI":"10.3348\/kjr.2013.14.5.776","article-title":"An immunoglobulin G4-related sclerosing disease of the small bowel: CT and small bowel series findings","volume":"14","author":"Ko","year":"2013","journal-title":"Korean J Radiol"},{"key":"2024083002025763900_R10","doi-asserted-by":"crossref","first-page":"3303","DOI":"10.1007\/s10620-012-2267-4","article-title":"Histologically confirmed IgG4-related small intestinal lesions diagnosed via double balloon enteroscopy","volume":"57","author":"Fujita","year":"2012","journal-title":"Dig Dis Sci"},{"key":"2024083002025763900_R11","doi-asserted-by":"crossref","DOI":"10.1002\/deo2.76","article-title":"Immunoglobulin G4-related disease accompanying a small intestinal ulcer: a 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