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CASE REPORT
Year : 2020  |  Volume : 31  |  Issue : 6  |  Page : 285-287

Immunoglobulin g4-related bilateral kidney disease: The clinical course and outcome: A case report


Department of Surgery, Division of Urology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand

Correspondence Address:
Worapat Attawettayanon
Department of Surgery, Division of Urology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/UROS.UROS_31_20

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Immunoglobulin G4-related disease (IgG4-RD) is uncommon and is characterized by dense tissue infiltration of IgG4-positive plasma cells or mass-like sclerosing lesions. In addition, it can involve any anatomic site, which has frequently elevated serum IgG4 concentrations. Japanese gastroenterologists are the ones who first discussed the concept of IgG4-RD; they first introduced the term IgG4-related kidney disease (IgG4-RKD), which refers to the involvement of the kidney and its surrounding tissues. Common urologic indicators of IgG4-RKD typically include subacute pain, on the detection of a tumor-like mass or enlargement, with or without tubulointerstitial nephritis. Conventional imaging computed tomography and magnetic resonance imaging are of limited usefulness in determining IgG4-RKD. The gold-standard for the diagnosis of IgG4-RD is the identification of typical histopathological features of dense lymphoplasmacytic infiltration, storiform fibrosis (an irregular cartwheel like fibrotic pattern), and obliterative phlebitis; these are the three hallmarks of IgG4-RD. The current report discusses a case of IgG4-RKD, who came into our hospital with chronic flank pain.


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