Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report.

Abstract:

RATIONALE:Immunoglobulin G4-related disease (IgG4-RD) is regarded as an immune-mediated systemic fibroinflammatory disease. Several studies have linked IgG4-RD to infections such as tuberculosis and actinomycosis. However, the coexistence of IgG4-RD and non-tuberculous mycobacterium (NTM) in a single pulmonary nodule has not been reported yet. PATIENT CONCERNS:A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT. DIAGNOSIS:Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made. INTERVENTIONS:Antibiotic treatment was applied for pneumonia developed after surgery. The patient was also supported by extracorporeal membrane oxygenation and mechanical ventilation since his pneumonia was refractory to medical treatment. OUTCOMES:The patient expired on the 60th postoperative day due to multiple organ failure. LESSONS:IgG4-RD can occur singularly or accompanied by other diseases. We report a solitary pulmonary nodule caused by NTM and concurrent IgG4-RD, suggesting a possible association between these 2 entities. Immunologic relations between IgG4-RD and accompanying infection should be further investigated.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Bae K,Jung An H,Jeon KN,Hyun Song D,Kim SH,Kim HC

doi

10.1097/MD.0000000000018179

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

e18179

issue

48

eissn

0025-7974

issn

1536-5964

pii

00005792-201911290-00079

journal_volume

98

pub_type

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