{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:03:03Z","timestamp":1789959783700,"version":"4.0.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Paragonimiasis is a food-borne parasitic disease caused by lung flukes belonging to the genus\n                      <jats:italic>Paragonimus<\/jats:italic>\n                      . It can produce pulmonary, pleural, and other organ manifestations that overlap clinically, radiologically, and histopathologically with malignancy, tuberculosis, and immune-mediated disorders. Elevated total serum immunoglobulin G4 (IgG4) concentrations and IgG4-positive plasma cell infiltration may mimic IgG4-related disease (IgG4-RD), but quantitative serum IgG4 levels in paragonimiasis have not been systematically characterized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multi-database scoping review of human paragonimiasis case reports and case series published from January 1, 1965, to December 31, 2025. PubMed, Ichushi-Web, Chinese National Knowledge Infrastructure (CNKI), and KoreaMed were searched using database-specific strategies, supplemented by multilingual Google Scholar checks. The review was reported in accordance with the PRISMA-ScR checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 610 reports comprising 886 cases, quantitative serum IgG4 values were reported in 10 reports (1.6%) and 12 cases (1.4%). The countries of first-author affiliation were Japan (\n                      <jats:italic>n<\/jats:italic>\n                      = 6), China (\n                      <jats:italic>n<\/jats:italic>\n                      = 2), Thailand (\n                      <jats:italic>n<\/jats:italic>\n                      = 1), and France (\n                      <jats:italic>n<\/jats:italic>\n                      = 1), and all reports were published in 2012 or later. The 12 cases included pulmonary, pleural\/intrathoracic, pericardial, central nervous system, and adrenal presentations. Among the 11 cases reported in mass concentration units, serum IgG4 values ranged from 94.1 to 3,350\u00a0mg\/dL, and 10 values were elevated. The remaining case was reported as elevated (1,990\u00a0IU\/mL) but was not converted to mass concentration units. Tissue pathology was described in 8 cases, and IgG4-positive plasma cell infiltration, IgG4-positive inflammation, or an increased tissue IgG4\/IgG ratio was reported in 4 cases. None of the pathology reports described storiform fibrosis or obliterative phlebitis, which are hallmarks of IgG4-RD. Based on the information available in the original publications, none of the 12 cases were mapped as probable or definite IgG4-RD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Quantitative serum IgG4 values are rarely reported in paragonimiasis case literature, and selective testing and reporting precluded estimation of the prevalence of serum IgG4 elevation. Serum IgG4 elevation and IgG4-positive plasma cells should be interpreted together with exposure history, parasite-directed evidence, and histopathology. Early consideration of paragonimiasis may prevent delayed diagnosis and inappropriate immunosuppression owing to misdiagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-026-01080-9","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:35:21Z","timestamp":1789958121000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative total serum IgG4 reporting in human paragonimiasis: a scoping review"],"prefix":"10.1186","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-258X","authenticated-orcid":false,"given":"Hidenori","family":"Takahashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugo","family":"Satake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nagamatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Hirose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mio","family":"Toyama-Kosaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Ota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miwa","family":"Morikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mio","family":"Kokubo-Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Shinkai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"3","key":"1080_CR1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1128\/CMR.00103-12","volume":"26","author":"JH Diaz","year":"2013","unstructured":"Diaz JH. Paragonimiasis acquired in the United States: native and nonnative species. Clin Microbiol Rev. 2013;26(3):493\u2013504.","journal-title":"Clin Microbiol Rev"},{"issue":"6","key":"1080_CR2","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1128\/JCM.02424-07","volume":"46","author":"N Zarrin-Khameh","year":"2008","unstructured":"Zarrin-Khameh N, Citron DR, Stager CE, Laucirica R. Pulmonary paragonimiasis diagnosed by fine-needle aspiration biopsy. J Clin Microbiol. 2008;46(6):2137\u201340.","journal-title":"J Clin Microbiol"},{"issue":"4","key":"1080_CR3","first-page":"3437","volume":"23","author":"S Watanabe","year":"2003","unstructured":"Watanabe S, Nakamura Y, Kariatsumari K, Nagata T, Sakata R, Zinnouchi S, et al. Pulmonary paragonimiasis mimicking lung cancer on FDG-PET imaging. 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The authors independently reviewed, revised, and verified all extracted data and manuscript content and take full responsibility for the final manuscript.","order":1,"name":"Ethics","label":"Use of artificial intelligence tools","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The clinical research ethics review committee of Tokyo Shinagawa Hospital confirmed that formal ethical approval was not required for this scoping review, as the review was based exclusively on previously published studies.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"206"}}