Abstract
We describe a case of a 57-year-old woman with isolated immunoglobulin G4-related disorder affecting her lacrimal glands. Pre-treatment 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) showed diffuse enlargement and increased FDG uptake in both lacrimal glands. After immunosuppressive treatment, 18F-FDG PET/CT showed no significant FDG uptake, and the sizes of both glands returned to normal.
Keywords:
Lacrimal, IgG4, FDG, PET, treatment
Ethics
Informed Consent: Informed consent was obtained from the patient for the use of their imaging data.
Authorship Contributions
Surgical and Medical Practices: A.K., S.A., Concept: A.K., S.A., O.E.Ş., L.U.B., S.S., K.S., H.B.S., Design: A.K., S.A., Data Collection or Processing: A.K., S.A., Analysis or Interpretation: A.K., S.A., O.E.Ş., L.U.B., S.S., K.S., H.B.S., Literature Search: A.K., Writing: A.K.
Conflict of Interest: No conflicts of interest were declared by the authors.
Financial Disclosure: The authors declare that this study has received no financial support.
References
1
Ren H, Mori N, Sato S, Mugikura S, Masamune A, Takase K. American College of Rheumatology and the European League Against Rheumatism classification criteria for IgG4-related disease: an update for radiologists. Jpn J Radiol. 2022;40:876-893.
2
Hao FY, Yang FX, Bian HY, Zhao X. Immunoglobulin G4-related lymph node disease with an orbital mass mimicking castleman disease: a case report. World J Clin Cases. 2021;9:10999-11006.
3
Perugino CA, Stone JH. IgG4-related disease: an update on pathophysiology and implications for clinical care. Nat Rev Rheumatol. 2020;16:702-714.
4
Sekiguchi H, Horie R, Kanai M, Suzuki R, Yi ES, Ryu JH. IgG4-related disease: retrospective analysis of one hundred sixty-six patients. Arthritis Rheumatol. 2016;68:2290-2299.
5
Kuroda N, Nao T, Fukuhara H, Karashima T, Inoue K, Taniguchi Y, Takeuchi M, Zen Y, Sato Y, Notohara K, Yoshino T. IgG4-related renal disease: clinical and pathological characteristics. Int J Clin Exp Pathol. 2014;7:6379-6385.
6
Wallace ZS, Naden RP, Chari S, Choi H, Della-Torre E, Dicaire JF, Hart PA, Inoue D, Kawano M, Khosroshahi A, Kubota K, Lanzillotta M, Okazaki K, Perugino CA, Sharma A, Saeki T, Sekiguchi H, Schleinitz N, Stone JR, Takahashi N, Umehara H, Webster G, Zen Y, Stone JH; American College of Rheumatology/European League Against Rheumatism IgG4-Related Disease Classification Criteria Working Group. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease. Arthritis Rheumatol. 2020;72:7-19.
7
Tang CYL, Chua WM, Cheng LTJ, Fong W, Zaheer S, Lam WW. 18 F-FDG PET/CT manifestations of IgG4-related disease. Br J Radiol. 2021;94:20210105.
8
Zhang J, Chen H, Ma Y, Xiao Y, Niu N, Lin W, Wang X, Liang Z, Zhang F, Li F, Zhang W, Zhu Z. Characterizing IgG4-related disease with 18 F-FDG PET/CT: a prospective cohort study. Eur J Nucl Med Mol Imaging. 2014;41:1624-1634.
9
Bai Z, Zhou T, Yu Z, Chen Y, Dong L. Clinical value of 18 F-FDG PET/CT in IgG4-related disease. Ann Nucl Med. 2022;36:651-660.
10
Mitamura K, Arai-Okuda H, Yamamoto Y, Norikane T, Takami Y, Fujimoto K, Wakiya R, Ozaki H, Dobashi H, Nishiyama Y. Disease activity and response to therapy monitored by [ 18 F]FDG PET/CT using volume-based indices in IgG4-related disease. EJNMMI Res. 2020;10:153.
11
Ebbo M, Grados A, Guedj E, Gobert D, Colavolpe C, Zaidan M, Masseau A, Bernard F, Berthelot JM, Morel N, Lifermann F, Palat S, Haroche J, Mariette X, Godeau B, Bernit E, Costedoat-Chalumeau N, Papo T, Hamidou M, Harlé JR, Schleinitz N. Usefulness of 2-[ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging and evaluation of treatment response in IgG4-related disease: a retrospective multicenter study. Arthritis Care Res (Hoboken). 2014;66:86-96.
12
Fu Z, Chen G, Liu M, Li Z, Li Q. 18 F-FDG PET/CT findings in a patient with IgG4-related sclerosing mesenteritis. Clin Nucl Med. 2018;43:294-295.
13
Elsobky S, Dattani V, Wagner T, Mandumula S, Tavare A. FDG PET/CT in sacroiliac IgG4 disease. Clin Nucl Med. 2021;46:e548-e550.


