IgG4-related inflammatory pseudotumor of the kidney mimicking renal cell carcinoma: A case report

Cai, Yi; Li, Hanzhong; Zhang, Yushi

doi:10.3892/ol.2016.4408

Cited by 15 publications

(12 citation statements)

References 14 publications

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“…Using diffusion-weighted magnetic resonance imaging (MRI), a recent study reported 100% sensitivity with respect to computed tomography (CT)[ 45 ]. However, a caveat is that when a solid mass is observed, it may be misdiagnosed as a malignant neoplasm and lead to an unnecessary nephrectomy[ 46 , 47 ].…”

Section: Igg4 Related Tinmentioning

confidence: 99%

Immunoglobulin G4-related kidney diseases: An updated review

Salvadori¹,

Tsalouchos²

2018

WJN

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This review will encompass definition, pathogenesis, renal clinical manifestations and treatment of immunoglobulin G4-related diseases (IgG4-RDs). IgG4-RD is a recently recognized clinical entity that often involves multiple organs and is characterized by high levels of serum immunoglobulins G4, dense infiltration of IgG4+ cells and storiform fibrosis. Cellular immunity, particularly T-cell mediated immunity, has been implicated in the pathogenesis of IgG4-RDs. The most frequent renal manifestations of IgG4-RD are IgG4-related tubulointerstitial nephritis, membranous glomerulopathy and obstructive nephropathy secondary to urinary tract obstruction due to IgG4-related retroperitoneal fibrosis. IgG4-RD diagnosis should be based on specific histopathological findings, confirmed by tissue immunostaining, typical radiological findings and an appropriate clinical context. The first line treatment is the steroids with two warnings: Steroid resistance and relapse after discontinuation. In the case of steroid resistance, B cell depleting agents as rituximab represent the second-line treatment. In the case of relapse after discontinuation, steroid treatment may be associated with steroid sparing agents. Since the disease has been only recently identified, more prospective, long-term studies are needed to an improved understanding and a more correct and safe treatment.

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Section: Igg4 Related Tinmentioning

confidence: 99%

Immunoglobulin G4-related kidney diseases: An updated review

Salvadori¹,

Tsalouchos²

2018

WJN

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“…Es una lesión que mimetiza a un carcinoma renal y resulta una forma de presentación de la enfermedad sumamente inusual, con menos de cinco casos reportados en la literatura hasta el día de hoy 51 . Es difícil diferenciar entre un pseudotumor renal secundario a ER-IgG4 y una lesión maligna basándonos solo en los estudios de imagen 52 .…”

Section: Pseudotumor Renalunclassified

“…La resonancia magnética puede mostrar tumores renales isointensos o hipointensos en T1, e imágenes hipointensas en T2, y mostrar realce homogéneo tras la administración de medio de contraste 53 . El diagnóstico diferencial definitivo lo dará una biopsia, y el tratamiento será mediante corticoesteroides, con los cuales la lesión mejorará significativamente, aumentando la función renal y disminuyendo la concentración de IgG4 circulante 51 .…”

Section: Pseudotumor Renalunclassified

Manifestaciones urológicas de la enfermedad relacionada con la inmunoglobulina G4

Carrillo-Córdova¹,

Carrillo-Córdova²,

Vitar-Sandoval³

et al. 2019

CIRU

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Immunoglobulin G4 related disease (IgG4-RD) is a fibro-inflammatory disease of unknown etiology, characterized by lesions in the form of tumors, elevated serum IgG4 levels, plasma cells with significant IgG4 infiltration, accompanied by phlebitis obliterans and fibrosis. This disease usually has multiorgan disease, including pancreas, biliary tract, salivary glands, peri orbital tissues, kidneys, lungs, lymph nodes and retro peritoneum. IgG4-RD mainly affects men with a predominance of age by young adults until old age. The clinical manifestations of IgG4-RD, depend mainly on the organs affected and the response to steroids. His forecast is not yet clear. Within the affected urogenital organs can be observed kidney, retroperitoneum, ureter, bladder, urachus, testis/epididymis, paratesticular region, prostate and urethra.

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“…It is important to recognize IgG4-related inflammatory pseudotumor and distinguish it from renal malignant tumor to avoid unnecessary nephrectomy [162]. Another mimicker of IgG4-RKD is AAV, which can be present with elevated serum IgG4 levels and similar organ manifestations compared to IgG4-RD [163].…”

Section: Eosinophilia In Kidney Diseasementioning

confidence: 99%

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

Gauckler

Smıth

Mayer

et al. 2018

JCM

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Peripheral blood eosinophilia (PBE), defined as 500 eosinophils or above per microliter (µL) blood, is a condition that is not uncommon but often neglected in the management of patients with chronic kidney disease (CKD), acute kidney injury (AKI), or patients on renal replacement therapy (RRT). The nature of PBE in the context of kidney diseases is predominantly secondary or reactive and has to be distinguished from primary eosinophilic disorders. Nonetheless, the finding of persistent PBE can be a useful clue for the differential diagnosis of underdiagnosed entities and overlapping syndromes, such as eosinophilic granulomatosis with polyangiitis (EGPA), IgG4-related disease (IgG4-RD), acute interstitial nephritis (AIN), or the hypereosinophilic syndrome (HES). For patients on RRT, PBE may be an indicator for bio-incompatibility of the dialysis material, acute allograft rejection, or Strongyloides hyperinfection. In a subset of patients with EGPA, eosinophils might even be the driving force in disease pathogenesis. This improved understanding is already being used to facilitate novel therapeutic options. Mepolizumab has been licensed for the management of EGPA and is applied with the aim to abrogate the underlying immunologic process by blocking interleukin-5. The current article provides an overview of different renal pathologies that are associated with PBE. Further scientific effort is required to understand the exact role and function of eosinophils in these disorders which may pave the way to improved interdisciplinary management of such patients.

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IgG4-related inflammatory pseudotumor of the kidney mimicking renal cell carcinoma: A case report

Cited by 15 publications

References 14 publications

Immunoglobulin G4-related kidney diseases: An updated review

Immunoglobulin G4-related kidney diseases: An updated review

Manifestaciones urológicas de la enfermedad relacionada con la inmunoglobulina G4

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

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