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Enfermedad por inmunoglobulina G4 con afectación pancreática: el imitador de malignidad / Immunoglobulin G4 disease with pancreatic affectation: the mimicker of malignancy
Resumen
Resumen
Introducción: la enfermedad relacionada con la subclase 4 de inmunoglobulina G (IgG4 ER) se caracteriza por niveles séricos elevados de IgG4 e infiltración tisular por células plasmáticas positivas para IgG4. Tiene una presentación clínica variada y el diagnóstico definitivo requiere una rigurosa correlación clínico-patológica.
Caso clínico: paciente del sexo masculino de 47 años con antecedente de pérdida de peso de 35 kg durante 2 años, acompañada de presencia de nódulos pulmonares y alteraciones en la morfología pancreática detectadas por imagen, lo cual se evaluó previamente como probable neoplasia de páncreas; sin embargo, durante el abordaje se sospechó la presencia de IgG4 ER, por lo que se solicitaron los niveles séricos de IgG4 y una biopsia de glándula submaxilar, los cuales cumplieron con los criterios diagnósticos, por lo que se inició tratamiento con rituximab con adecuada respuesta.
Conclusión: la enfermedad por IgG4 es una enfermedad poco común que no se considera como diagnóstico diferencial, lo cual lleva a retraso diagnóstico.
Abstract
Background: Immunoglobulin G subclass 4-related disease (IgG4-RD) is characterized by elevated serum IgG4 levels and tissue infiltration by IgG4-positive plasma cells. It has a varied clinical presentation, and definitive diagnosis requires rigorous clinicopathological correlation.
Clinical case: 47-year-old male patient with a history of weight loss of 35 kg over 2 years, accompanied by the presence of pulmonary nodules and alterations in pancreatic morphology detected by imaging, which was assessed as a probable pancreatic neoplasm; however, IgG4-RD was suspected during the approach, which is why serum IgG4 levels and a biopsy of the submandibular gland were requested, fulfilling the diagnostic criteria, consequently starting treatment with rituximab with an adequate response.
Conclusion: IgG4-RD is a rare disease that many times is not considered as a differential
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DOI: https://doi.org/10.24875/10.5281/zenodo.10998957
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