{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:43:16Z","timestamp":1792248196290,"version":"4.4.0"},"reference-count":10,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"Summary<\/jats:title>\n A 73-year-old man with Hashimoto's thyroiditis (HT) suffered from purpura on the lower legs. He was diagnosed with IgG4-related disease (IgG4-RD) with serum IgG4 elevation and dacryo-sialadenitis confirmed histologically. Serum Th2 and Treg cytokines, interleukin 7 (IL7), IL8 and Th2 chemokine levels were elevated, while skewed Th1 balance was seen in fluorescence-activated cell sorting (FACS). Therefore, preferential Th1 balance in HT appeared to be followed by IgG4-RD characterized with Th2 and Treg polarization. The commencement of steroid therapy dramatically exacerbated clinical manifestations including IgG4-RD-associated HT. The measurement of cytokine and chemokine levels as well as FACS analysis in the development of IgG4-RD seemed to be beneficial. In conclusion, an innovative association of HT, IgG4-RD and vasculitis was observed. This report also offers novel diagnostic and therapeutic approaches for IgG4-RD.<\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n Recently, a subtype of HT has been considered to be a thyroid manifestation of IgG4-RD, although the etiology of IgG4-RD is not established yet.<\/jats:p>\n <\/jats:list-item>\n \n Immunologically a close association between HT and vasculitis was reported.<\/jats:p>\n <\/jats:list-item>\n \n Leukocytoclastic vasculitis is a rare skin presentation of IgG4-RD.<\/jats:p>\n <\/jats:list-item>\n \n In the current case, during the course of HT, IgG4-RD and leukocytoclastic vasculitis occurred; thus, innate immunity and acquired immunity seem to be involved in the development of IgG4-RD.<\/jats:p>\n <\/jats:list-item>\n \n The measurement of cytokine and chemokines appeared to be beneficial in the development of IgG4-RD.<\/jats:p>\n <\/jats:list-item>\n \n Remarkably, effectiveness of steroid therapy for HT suggested presence of IgG4-RD-associated HT. Therefore, this report highlights the pathogenesis of IgG4-RD and proposes novel therapeutic mechanisms. Clinicians should pay attention to the development of IgG4-RD and vasculitis during long course of HT.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-16-0004","type":"journal-article","created":{"date-parts":[[2016,3,10]],"date-time":"2016-03-10T02:29:03Z","timestamp":1457576943000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":6,"title":["A novel immunopathological association of IgG4-RD and vasculitis with Hashimoto's thyroiditis"],"prefix":"10.1530","volume":"2016","author":[{"given":"Hiroto","family":"Minamino","sequence":"first","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan"},{"name":"2 Department of Diabetes and Endocrinology, Wakayama Red Cross Hospital, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidefumi","family":"Inaba","sequence":"additional","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ariyasu","sequence":"additional","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Furuta","sequence":"additional","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Nishi","sequence":"additional","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yoshimasu","sequence":"additional","affiliation":[{"name":"3 Department of Dermatology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"4 Department of Hematology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"5 Department of Respiratory Medicine & Medical Oncology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Tsuchihashi","sequence":"additional","affiliation":[{"name":"6 Department of Otolaryngology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiyoshi","family":"Kojima","sequence":"additional","affiliation":[{"name":"7 Department of Human Pathology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-ichi","family":"Murata","sequence":"additional","affiliation":[{"name":"7 Department of Human Pathology, Wakayama Medical University, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Inoue","sequence":"additional","affiliation":[{"name":"2 Department of Diabetes and Endocrinology, Wakayama Red Cross Hospital, Wakayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Akamizu","sequence":"additional","affiliation":[{"name":"1 The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, 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