부산대학교 도서관

Background. Immunoglobulin (Ig) G4-related disease is characterized by the infiltration of IgG4-positive plasma cells into various organs. A pathological diagnosis based on bronchoscopic or surgical biopsy is required for the definitive diagnosis of IgG4-related respiratory disease. Case Presentation. An 82-year-old man with a 15-year history of hypergammaglobulinemia was examined for bilateral pleural effusion that had been unresponsive to diuretics for approximately half a year. IgG and IgG4 levels in the blood and IgG levels in the pleural effusion were elevated, and thoracoscopy was performed under local anesthesia. A pleural biopsy of the dark brown lesion was performed. The biopsy specimen revealed the infiltration of IgG4-positive plasma cells into the tissue, leading to a diagnosis of IgG4-related pleuritis. The patient was thus treated with prednisolone, and the pleural effusion improved. Conclusion. A pleural biopsy via thoracoscopy under local anesthesia is useful for diagnosing of IgG4-related pleuritis and should be considered if the disease is suspected.