Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report
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 pulmonar...
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| Veröffentlicht in: | Medicine (Baltimore) 2019-11, Vol.98 (48), p.e18179-e18179 |
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| container_title | Medicine (Baltimore) |
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| creator | Bae, Kyungsoo Jung An, Hyo Jeon, Kyung Nyeo Hyun Song, Dae Kim, Sung Hwan Kim, Ho Cheol |
| description | 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.
A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT.
Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made.
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.
The patient expired on the 60th postoperative day due to multiple organ failure.
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. |
| doi_str_mv | 10.1097/MD.0000000000018179 |
| format | Article |
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A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT.
Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made.
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.
The patient expired on the 60th postoperative day due to multiple organ failure.
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.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000018179</identifier><identifier>PMID: 31770270</identifier><language>eng</language><publisher>United States: the Author(s). Published by Wolters Kluwer Health, Inc</publisher><subject>Aged ; Anti-Bacterial Agents - administration & dosage ; Biopsy - methods ; Clinical Case Report ; Extracorporeal Membrane Oxygenation - methods ; Fatal Outcome ; Humans ; Immunoglobulin G4-Related Disease - complications ; Immunoglobulin G4-Related Disease - diagnosis ; Immunoglobulin G4-Related Disease - physiopathology ; Lung - diagnostic imaging ; Lung - pathology ; Male ; Multiple Organ Failure - etiology ; Mycobacterium Infections, Nontuberculous - complications ; Mycobacterium Infections, Nontuberculous - diagnosis ; Mycobacterium Infections, Nontuberculous - pathology ; Mycobacterium Infections, Nontuberculous - therapy ; Nontuberculous Mycobacteria - isolation & purification ; Pneumonia - drug therapy ; Pneumonia - etiology ; Postoperative Complications - drug therapy ; Solitary Pulmonary Nodule - complications ; Solitary Pulmonary Nodule - microbiology ; Solitary Pulmonary Nodule - pathology ; Solitary Pulmonary Nodule - surgery ; Thoracic Surgery, Video-Assisted - methods ; Tomography, X-Ray Computed - methods</subject><ispartof>Medicine (Baltimore), 2019-11, Vol.98 (48), p.e18179-e18179</ispartof><rights>the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3559-d7cb834bb3265848abc49e365c26eb631719f4c402a9fd3c67ad3cc4144936933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890359/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890359/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,27907,27908,53774,53776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31770270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bae, Kyungsoo</creatorcontrib><creatorcontrib>Jung An, Hyo</creatorcontrib><creatorcontrib>Jeon, Kyung Nyeo</creatorcontrib><creatorcontrib>Hyun Song, Dae</creatorcontrib><creatorcontrib>Kim, Sung Hwan</creatorcontrib><creatorcontrib>Kim, Ho Cheol</creatorcontrib><title>Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>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.
A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT.
Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made.
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.
The patient expired on the 60th postoperative day due to multiple organ failure.
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.</description><subject>Aged</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Biopsy - methods</subject><subject>Clinical Case Report</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Fatal Outcome</subject><subject>Humans</subject><subject>Immunoglobulin G4-Related Disease - complications</subject><subject>Immunoglobulin G4-Related Disease - diagnosis</subject><subject>Immunoglobulin G4-Related Disease - physiopathology</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - pathology</subject><subject>Male</subject><subject>Multiple Organ Failure - etiology</subject><subject>Mycobacterium Infections, Nontuberculous - complications</subject><subject>Mycobacterium Infections, Nontuberculous - diagnosis</subject><subject>Mycobacterium Infections, Nontuberculous - pathology</subject><subject>Mycobacterium Infections, Nontuberculous - therapy</subject><subject>Nontuberculous Mycobacteria - isolation & purification</subject><subject>Pneumonia - drug therapy</subject><subject>Pneumonia - etiology</subject><subject>Postoperative Complications - drug therapy</subject><subject>Solitary Pulmonary Nodule - complications</subject><subject>Solitary Pulmonary Nodule - microbiology</subject><subject>Solitary Pulmonary Nodule - pathology</subject><subject>Solitary Pulmonary Nodule - surgery</subject><subject>Thoracic Surgery, Video-Assisted - methods</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9vFSEUxYnR2GfbT2BiWLqZyt9hcGHSvGpt0qYbXROGudM3ysAThtZ-e3m-WrUs4AZ-93DgIPSakhNKtHp3dXZC_g7aUaWfoRWVvG2kbsVztCKEyUZpJQ7Qq5y_VYgrJl6iA06VIkyRFUrrCD-nvEBwgOOIQwxL6SG54mPJeL53sbdugTSVGdsw4Iubc9Ek8HaBAQ9TBpsBTwFbnKOfFpvu8bb4OYZdFeJQPLzHp9jtsATbmJYj9GK0PsPxw3qIvn76-GX9ubm8Pr9Yn142jkupm0G5vuOi7zlrZSc62zuhgbfSsRb6tj6B6lE4QZjV48Bdq2ydnaBCaN5qzg_Rh73utvQzDA7Ckqw32zTN1ZuJdjL_n4RpY27irWk7TbjUVeDtg0CKPwrkxcxTduC9DVA_xzBONdWaSVpRvkddijknGB-vocTs0jJXZ-ZpWrXrzb8OH3v-xFMBsQfuoq8Z5O--3EEyG7B-2fzWk0qzhpFqhDJNmrpTdX8BEkWhmA</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Bae, Kyungsoo</creator><creator>Jung An, Hyo</creator><creator>Jeon, Kyung Nyeo</creator><creator>Hyun Song, Dae</creator><creator>Kim, Sung Hwan</creator><creator>Kim, Ho Cheol</creator><general>the Author(s). Published by Wolters Kluwer Health, Inc</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191101</creationdate><title>Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report</title><author>Bae, Kyungsoo ; Jung An, Hyo ; Jeon, Kyung Nyeo ; Hyun Song, Dae ; Kim, Sung Hwan ; Kim, Ho Cheol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3559-d7cb834bb3265848abc49e365c26eb631719f4c402a9fd3c67ad3cc4144936933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Biopsy - methods</topic><topic>Clinical Case Report</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Fatal Outcome</topic><topic>Humans</topic><topic>Immunoglobulin G4-Related Disease - complications</topic><topic>Immunoglobulin G4-Related Disease - diagnosis</topic><topic>Immunoglobulin G4-Related Disease - physiopathology</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - pathology</topic><topic>Male</topic><topic>Multiple Organ Failure - etiology</topic><topic>Mycobacterium Infections, Nontuberculous - complications</topic><topic>Mycobacterium Infections, Nontuberculous - diagnosis</topic><topic>Mycobacterium Infections, Nontuberculous - pathology</topic><topic>Mycobacterium Infections, Nontuberculous - therapy</topic><topic>Nontuberculous Mycobacteria - isolation & purification</topic><topic>Pneumonia - drug therapy</topic><topic>Pneumonia - etiology</topic><topic>Postoperative Complications - drug therapy</topic><topic>Solitary Pulmonary Nodule - complications</topic><topic>Solitary Pulmonary Nodule - microbiology</topic><topic>Solitary Pulmonary Nodule - pathology</topic><topic>Solitary Pulmonary Nodule - surgery</topic><topic>Thoracic Surgery, Video-Assisted - methods</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bae, Kyungsoo</creatorcontrib><creatorcontrib>Jung An, Hyo</creatorcontrib><creatorcontrib>Jeon, Kyung Nyeo</creatorcontrib><creatorcontrib>Hyun Song, Dae</creatorcontrib><creatorcontrib>Kim, Sung Hwan</creatorcontrib><creatorcontrib>Kim, Ho Cheol</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bae, Kyungsoo</au><au>Jung An, Hyo</au><au>Jeon, Kyung Nyeo</au><au>Hyun Song, Dae</au><au>Kim, Sung Hwan</au><au>Kim, Ho Cheol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>98</volume><issue>48</issue><spage>e18179</spage><epage>e18179</epage><pages>e18179-e18179</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>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.
A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT.
Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made.
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.
The patient expired on the 60th postoperative day due to multiple organ failure.
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.</abstract><cop>United States</cop><pub>the Author(s). Published by Wolters Kluwer Health, Inc</pub><pmid>31770270</pmid><doi>10.1097/MD.0000000000018179</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0025-7974 |
| ispartof | Medicine (Baltimore), 2019-11, Vol.98 (48), p.e18179-e18179 |
| issn | 0025-7974 1536-5964 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6890359 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Wolters Kluwer Open Health; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Anti-Bacterial Agents - administration & dosage Biopsy - methods Clinical Case Report Extracorporeal Membrane Oxygenation - methods Fatal Outcome Humans Immunoglobulin G4-Related Disease - complications Immunoglobulin G4-Related Disease - diagnosis Immunoglobulin G4-Related Disease - physiopathology Lung - diagnostic imaging Lung - pathology Male Multiple Organ Failure - etiology Mycobacterium Infections, Nontuberculous - complications Mycobacterium Infections, Nontuberculous - diagnosis Mycobacterium Infections, Nontuberculous - pathology Mycobacterium Infections, Nontuberculous - therapy Nontuberculous Mycobacteria - isolation & purification Pneumonia - drug therapy Pneumonia - etiology Postoperative Complications - drug therapy Solitary Pulmonary Nodule - complications Solitary Pulmonary Nodule - microbiology Solitary Pulmonary Nodule - pathology Solitary Pulmonary Nodule - surgery Thoracic Surgery, Video-Assisted - methods Tomography, X-Ray Computed - methods |
| title | Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report |
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