TY - JOUR
T1 - Immunoglobulin G4 sinusitis in association with aspirin-exacerbated respiratory disease
AU - Johal, Kirti
AU - Welch, Kevin
AU - Peters, Anju
N1 - Publisher Copyright:
Copyright © 2017, OceanSide Publications, Inc., U.S.A.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Immunoglobulin G4 (IgG4) related disease is a systemic inflammatory disease characterized by tumor-like tissue infiltration with IgG4 positive (IgG4) plasma cells. Aspirin-exacerbated respiratory disease (AERD) is defined as asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to cyclooxygenase-1 inhibitors. Objective: We described a case of a non-smoking 61-year-old male with prior NSAID sensitivity who presented with a 1-year history of left eye proptosis associated with chronic nasal symptoms, ultimately identified as concurrent AERD and IgG4 sinusitis. Methods: The patient was evaluated in the clinic and diagnosed by using clinical, radiographic, and surgical biopsy findings. Results: Although initial concern was greatest for malignancy, a biopsy specimen confirmed the presence of a dense lymphoplasmacytic infiltrate and storiform fibrosis, associated with increased IgG4 plasma cells. Therefore, IgG4-related disease (RD) was identified in this patient with AERD. Conclusion: Shared type II inflammation may be responsible for the coexistence of IgG4-RD and AERD as observed in our patient. Health care workers must be cognizant of the simultaneous presentation of both IgG4-RD and AERD.
AB - Background: Immunoglobulin G4 (IgG4) related disease is a systemic inflammatory disease characterized by tumor-like tissue infiltration with IgG4 positive (IgG4) plasma cells. Aspirin-exacerbated respiratory disease (AERD) is defined as asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to cyclooxygenase-1 inhibitors. Objective: We described a case of a non-smoking 61-year-old male with prior NSAID sensitivity who presented with a 1-year history of left eye proptosis associated with chronic nasal symptoms, ultimately identified as concurrent AERD and IgG4 sinusitis. Methods: The patient was evaluated in the clinic and diagnosed by using clinical, radiographic, and surgical biopsy findings. Results: Although initial concern was greatest for malignancy, a biopsy specimen confirmed the presence of a dense lymphoplasmacytic infiltrate and storiform fibrosis, associated with increased IgG4 plasma cells. Therefore, IgG4-related disease (RD) was identified in this patient with AERD. Conclusion: Shared type II inflammation may be responsible for the coexistence of IgG4-RD and AERD as observed in our patient. Health care workers must be cognizant of the simultaneous presentation of both IgG4-RD and AERD.
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U2 - 10.2500/ajra.2017.31.4455
DO - 10.2500/ajra.2017.31.4455
M3 - Article
C2 - 28859705
AN - SCOPUS:85028759554
VL - 31
SP - 302
EP - 304
JO - American Journal of Rhinology and Allergy
JF - American Journal of Rhinology and Allergy
SN - 1945-8924
IS - 5
ER -