Periurethral Involvement of IgG4-Related Disease in an Elderly Woman Mimicking an Enlarged Prostate in Man
Authors: Hiroshi Yamamoto, Toshiro Fukushima, Hitoshi Yokoyama, Akihko Yoshizawa, Hideaki Hamano
Journal: Annals of Internal Medicine (2012)

Letters3 July 2012Periurethral Involvement of IgG4-Related Disease in an Elderly Woman Mimicking an Enlarged Prostate in ManHiroshi Yamamoto, MD, PhD, Toshiro Fukushima, MD, Hitoshi Yokoyama, MD, PhD, Akihko Yoshizawa, MD, PhD, and Hideaki Hamano, MD, PhDHiroshi Yamamoto, MD, PhDFrom Shinshu University School of Medicine, Matsumoto, Japan.Search for more papers by this author, Toshiro Fukushima, MDFrom Shinshu University School of Medicine, Matsumoto, Japan.Search for more papers by this author, Hitoshi Yokoyama, MD, PhDFrom Shinshu University School of Medicine, Matsumoto, Japan.Search for more papers by this author, Akihko Yoshizawa, MD, PhDFrom Shinshu University School of Medicine, Matsumoto, Japan.Search for more papers by this author, and Hideaki Hamano, MD, PhDFrom Shinshu University School of Medicine, Matsumoto, Japan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-1-201207030-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: IgG4–related disease is an emerging clinical entity that is characterized by dense infiltration of involved organs with IgG4-positive plasma cells and a high serum IgG4 concentration (1, 2). Disease manifestations include pancreatitis, sclerosing sialoadenitis, retroperitoneal fibrosis, prostatitis, and hilar and mediastinal lymphadenopathy, all of which respond to steroids (1–4).Objective: To report a new manifestation of IgG4-related disease.Case Report: In April 2011, a 79-year-old woman with urine retention was admitted to the hospital, where ultrasonography and computed tomography found a periurethral mass. She had been admitted with asthma 1 year earlier. At that time, chest computed tomography showed ...References1. Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012;22:21-30. [PMID: 22218969] CrossrefMedlineGoogle Scholar2. Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al; Research Program for Intractable Disease by Ministry of Health, Labor and Welfare (MHLW) Japan G4 team. A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. Mod Rheumatol. 2012;22:1-14. [PMID: 21881964] CrossrefMedlineGoogle Scholar3. Hamano H, Kawa S, Ochi Y, Unno H, Shiba N, Wajiki M, et al. Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet. 2002;359:1403-4. [PMID: 11978339] CrossrefMedlineGoogle Scholar4. Uehara T, Hamano H, Kawakami M, Koyama M, Kawa S, Sano K, et al. Autoimmune pancreatitis-associated prostatitis: distinct clinicopathological entity. Pathol Int. 2008;58:118-25. [PMID: 18199162] CrossrefMedlineGoogle Scholar5. Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. 2008;77:643-50. [PMID: 18350762] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Hiroshi Yamamoto, MD, PhD; Toshiro Fukushima, MD; Hitoshi Yokoyama, MD, PhD; Akihko Yoshizawa, MD, PhD; Hideaki Hamano, MD, PhDAffiliations: From Shinshu University School of Medicine, Matsumoto, Japan.Acknowledgment: The authors thank Dr. Sachie Fujita and Dr. Satoshi Kawakami (Department of Radiology, Shinshu University School of Medicine), and Kazuhiro Oguchi (Positron Emission Tomography Center, Aizawa Hospital) for radiologic studies and Dr. Keishi Kubo (First Department of Internal Medicine, Shinshu University School of Medicine) and Dr. Shigeyuki Kawa (Health, Safety and Environmental Management, Shinshu University) for helpful input and review of the manuscript.Grant Support: This study was funded by a Health and Labor Sciences Research Intractable Disease Grant from the Ministry of Health, Labor and Welfare (Tokyo, Japan).Disclosures: Dr. Yamamoto: Grant (money to institution): Intractable Disease, the Health and Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare; Support for travel to meetings for the study or other purposes: Intractable Disease, the Health and Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA rare case of IgG4-related disease masquerading as periurethral malignancy and review of the literatureImmunoglobulin G4-related disease involving the bladder wall and urethraOther Urogenital Lesions (Testis, Paratesticular Lesion, Bladder, Prostate etc.) 3 July 2012Volume 157, Issue 1Page: 78-79KeywordsComputed axial tomographyHospital medicineInflammationMagnetic resonance imagingPlasma cellsPositron emission tomographyProstate diseasesResearch grantsUrinary tract infectionsUrine ePublished: 3 July 2012 Issue Published: 3 July 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...