Gastric ulcer caused by immunoglobulin G4-related diseases: a case report

Abstract

Objective: To enhance the diagnosis and treatment of Immunoglobulin G4-related gastric disease. Method:One case of IgG4-related gastric disease in our hospital was presented and analyzed.Result: Patients with IgG4-related gastric disease usually showed nonspecific clinical symptoms such as abdominal discomfort, dull pain, anorexia, nausea and vomiting, anemia, weight loss, etc. By gastroscopy, we could divide IgG4-related gastro intestinal disease into two categories: organ enlargement and ulceration, whose histopathological features consisting of abundant infiltration of IgG4 positive lymphocytes, plasma cells, formation of lymph follicle. The lesion could spreading to every layer of the stomach, nerve, minute vessels and regional lymph nodes, which only existed in stomach that were not associated with other IgG4-related diseases. The diagnosis of the disease may refer to Japanese IgG4-related disease diagnostic criteria. We should identify it to exclude gastric cancer clinically. Treatment with steroids was given priority to, and surgery could be a complementary method. Conclusion:The incidence of IgG4 related-gastric disease is rare, and it is not difficult to diagnose and treat by analysis of the limited cases. It is of utmost importance for us to raise vigilance, consider IgG4-related disease and especially to accumulate more cases, explore its pathogenesis, clinical characteristics if possible.

Immunoglobulin G4-Related Disease Manifesting as Isolated, Typical, and Nontypical Gastroesophageal Lesion: A Research of Literature Review

“…A pathological specimen of complete gastrectomy showed extensive fibrosis with abundant infiltration of IgG4+ plasmacytes. Furthermore, Li et al [45] reported H. py-lori+ dual gastric ulcers with surrounding atrophic tissue and enlarged perigastric lymph nodes. The resected tissue showed submucosal fibrosis, dense lymphoplasmacytes, numerous lymphoid follicles, obliterated veins, and higher counts of IgG4+ plasmacytes.…”