{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:05:48Z","timestamp":1791295548886,"version":"4.1.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>An elevation in serum immunoglobulin (Ig) G4 concentrations at only one time point is not a definitive diagnostic marker for IgG4-related diseases. We report two cases of pulmonary paragonimiasis with elevated serum IgG4 concentrations. Patient 1 was a woman in her late 40s with cough and dyspnea for 1 week. Patient 2 was a woman in her late 60s with a cough, bloody sputum, chest pain, and wheezing for over 1 month. Patient 1 had eosinophilia, high IgE, IgG, and IgG4 concentrations, right pleural effusion, and lung lesions, resembling tuberculosis. Patient 2 had cavitary lung lesions, pleural involvement, and eosinophilia, and high IgE, IgG, and IgG4 concentrations, with a history of eating raw river crabs. Both patients tested positive for Paragonimus antibodies. Patient 1 received 2 months of anti-parasitic treatment, while Patient 2 had 1 week of treatment. Patient 2 showed improvement and was discharged with normalized Ig concentrations. Increased serum IgG4 concentrations, in conjunction with elevated concentrations of IgG, IgE and eosinophil counts, and a history of travel or residence in areas endemic for paragonimiasis, can be used to distinguish pulmonary paragonimiasis from other etiologies of pneumonia.<\/jats:p>","DOI":"10.1177\/03000605251317980","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T03:35:42Z","timestamp":1740368142000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6947-1424","authenticated-orcid":false,"given":"Pengyan","family":"Yin","sequence":"first","affiliation":[{"name":"Medical Laboratory Department, Southern Central Hospital of Yunnan Province 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