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Case reports in rheumatology 43건

  1. [해외논문]   Nasal Septal Perforation in Propylthiouracil-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis  

    Ishii, Yusho (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Shirai, Tsuyoshi (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Hoshi, Yousuke (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Fujita, Yoko (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Shirota, Yuko (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Fujii, Hiroshi (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Ishii, Tomonori (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan ) , Harigae, Hideo (Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan)
    Case reports in rheumatology v.2018 ,pp. 1 - 4 , 2018 , 2090-6889 ,

    초록

    Here, we present the case of a 29-year-old woman with nasal septal perforation and positive myeloperoxidase- (MPO-) anti-neutrophil cytoplasmic antibody (ANCA). She had been diagnosed with Graves' disease and had been treated with propylthiouracil (PTU) for 14 months. A biopsy of the nasal septum revealed an infiltration of inflammatory cells, with no evidence of malignancy or granulomatous change. Because of the use of PTU, destructive nasal lesion, and positive MPO-ANCA, she was diagnosed with drug-induced ANCA-associated vasculitis (AAV) and was treated with prednisolone and methotrexate after the cessation of PTU. Although PTU is known to be the medicine that induces drug-induced AAV, the manifestation of nasal septal perforation in drug-induced AAV is poorly identified. This is the rare case of drug-induced AAV which manifested only nasal septal perforation.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  2. [해외논문]   A Case of Atorvastatin-Associated Necrotizing Autoimmune Myopathy, Mimicking Idiopathic Polymyositis  

    Dixit, Ayushi (Icahn School of Medicine at Mount Sinai-Queens Hospital Center, Queens, NY, USA ) , Abrudescu, Adriana (Icahn School of Medicine at Mount Sinai-Queens Hospital Center, Queens, NY, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 3 , 2018 , 2090-6889 ,

    초록

    Statin-induced necrotizing autoimmune myopathy (SINAM) is a rare side effect of statin use which manifests as progressive muscle weakness. Because statins are a widely prescribed medication for coronary artery disease, hyperlipidemia, and many other diseases, many patients are at risk of developing SINAM or one of the many other statin-induced myopathies. Due to identification of an antibody specific to this disease, we were able to diagnose SINAM in a patient whose symptoms had progressed to the extent that they were debilitating. Our case describes SINAM in a patient undergoing treatment with a statin for an extended period of time, diagnosis of the disease process, treatment, and resolution of symptoms.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   Hemorrhagic Tamponade as Initial Manifestation of Systemic Lupus with Subsequent Refractory and Progressive Lupus Myocarditis Resulting in Cardiomyopathy and Mitral Regurgitation  

    Marijanovich, Nicole (Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA ) , Halalau, Alexandra (Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 4 , 2018 , 2090-6889 ,

    초록

    Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with a wide range of clinical and serological manifestations. Cardiac disease among patients with SLE is common and can involve the pericardium, myocardium, valves, conduction system, and coronary arteries. We are reporting a case of SLE in a young woman that is unique is unique in that initial symptoms consisted of pericarditis and hemorrhagic tamponade which remained progressive and resistant to aggressive immunosuppressive treatment and led to severe cardiomyopathy (ejection fraction of 25%) and severe (+4) mitral regurgitation. Her immunosuppressive treatment included hydroxychloroquine, high-dose steroids, intravenous immunoglobulins, azathioprine, and mycophenolate mofetil. Her disease progression was felt to be due to underlying uncontrolled SLE because the complement levels remained persistently low throughout the entire course and PET Myocardial Perfusion and Viability study showed stable persistent active inflammation. Eventually, she was treated with cyclophosphamide which led to improvement in ejection fraction to 55% with only mild mitral regurgitation.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   An Interesting Case of Neurobrucellosis Mimicking Neuropsychiatric Lupus  

    Bains, Ramandeep (UCLA-Olive View Rheumatology Program, Division of Rheumatology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA ) , Dahhan, Tamara (UCLA-Olive View Rheumatology Program, Division of Rheumatology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA ) , Belzowski, Annie (UCLA-Olive View Internal Medicine Program, Department of Medicine, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA ) , Heinze, Emil R. (UCLA-Olive View Rheumatology Program, Division of Rheumatology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA ) , Wong, Andrew L. (UCLA-Olive View Rheumatology Program, Division of Rheumatology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA ) , Clements, Philip J. (UCLA-Olive View Rheumatology Program, Division of Rheumatology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B182, Sylmar, CA 91342, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 5 , 2018 , 2090-6889 ,

    초록

    This case describes a patient presenting with acute onset papilledema, subacute strokes resulting in upper extremity weakness and numbness, arthritis, maculopapular rash, depressed C4 and CH50, and a high titer anti-double-stranded DNA antibody. The patient was given the diagnosis of probable systemic lupus erythematosus, which was supported by the Systemic Lupus International Collaborating Clinics (SLICC) criteria. He was aggressively treated for neuropsychiatric lupus (NPSLE) with pulse dose steroids and a dose of intravenous cyclophosphamide. Blood cultures drawn on admission later grew out 2/4 bottles of Gram-variable bacteria, speciated as Brucella melitensis by PCR. Serum Brucella serologies were also positive. On further evaluation, the patient noted a history of eating unpasteurized cheese in Mexico. Given these additional findings, the patient's presentation was most consistent with a diagnosis of neurobrucellosis. Steroids were tapered off, no further doses of cyclophosphamide were given, and a prolonged course of intravenous and oral antibiotic therapy was administered, resulting in complete resolution of the patient's presenting symptoms.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Aortic Aneurysm as a Complication of Granulomatosis with Polyangiitis Successfully Treated with Prednisolone and Cyclophosphamide: A Case Report and Review of the Literature  

    Niimi, Naoko (Department of Anesthesia, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan ) , Miyashita, Tomoko (Department of Internal Medicine and Rheumatology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan ) , Tanji, Kana (Department of Internal Medicine and Rheumatology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan ) , Hirai, Takuya (Department of Internal Medicine and Rheumatology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan ) , Watanabe, Kozo (Department of Internal Medicine and Rheumatology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan ) , Ikeda, Keigo (Department of Internal Medicine and Rheumatology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan ) , Morimoto, Shinji (Department of Internal Medicine and Rheumatology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan ) , Sekigawa, Iwao (Department of Internal Medicine and Rheumatology, Juntendo University Ur)
    Case reports in rheumatology v.2018 ,pp. 1 - 6 , 2018 , 2090-6889 ,

    초록

    A 57-year-old Japanese man was admitted to the hospital with back pain and fever, multiple lung nodules, and abdominal aortic aneurysm (AAA). Laboratory tests performed at admission showed an increased proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) level. Video-associated thoracoscopic lung biopsy was performed; pathologic examination showed granulation tissue with necrosis and multinucleated giant cells. The diagnosis of granulomatosis with polyangiitis (GPA) was confirmed on the basis of the clinical presentation, laboratory findings, and lung biopsy. All symptoms were ameliorated, and the serum level of PR3-ANCA declined following treatment with prednisolone and cyclophosphamide. Although the association of GPA with AAA is rare, GPA may be included among the large vessel vasculitides that can give rise to aortic aneurysm.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Eltrombopag Improves Refractory Thrombocytopenia in a Patient with Systemic Lupus Erythematosus  

    Shima, Natsuki (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Sumida, Keiichi (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Kawada, Masahiro (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Sekine, Akinari (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Yamanouchi, Masayuki (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Hiramatsu, Rikako (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Hayami, Noriko (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Hasegawa, Eiko (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Suwabe, Tatsuya (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Hoshino, Junichi (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Sawa, Naoki (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Takaichi, Kenmei (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan ) , Ohashi, Kenichi (Department of Pathology, Toranomon Hospital, Tokyo, Japan ) , Fujii, Takeshi (Department of Pathology, Toranomon Hospital, Tokyo, Japan ) , Ubara, Yoshifumi (Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan)
    Case reports in rheumatology v.2018 ,pp. 1 - 6 , 2018 , 2090-6889 ,

    초록

    A 42-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital for evaluation of severe thrombocytopenia. She was treated with steroids, intravenous cyclophosphamide, intravenous immunoglobulin, and plasma exchange, but her thrombocytopenia did not improve. Renal biopsy showed class IV-S(C) + V lupus nephritis, according to the classification of the International Society of Nephrology/Renal Pathology Society. The PA-IgG and serum thrombopoietin (TPO) levels were elevated. Her thrombocytopenia responded to off-label administration of eltrombopag, which was discontinued after 42 months. At 18 months after stopping eltrombopag, the platelet count was 19.3 × 10 4 / μ L. Eltrombopag may be a therapeutic option for SLE patients with severe thrombocytopenia refractory to conventional therapy.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  7. [해외논문]   Corrigendum to “NXP-2 Positive Dermatomyositis: A Unique Clinical Presentation”  

    Butt, Zeeshan (Internal Medicine Residency Program, Prince George's Hospital Center, 3001 Hospital Dr, Cheverly, MD 20785, USA ) , Patel, Leeza (Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA ) , Das, Manash K. (Internal Medicine Residency Program, Prince George's Hospital Center, 3001 Hospital Dr, Cheverly, MD 20785, USA ) , Mecoli, Christopher A. (Division of Rheumatology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA ) , Ramji, Alim (Division of Rheumatology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 1 , 2018 , 2090-6889 ,

    초록

    A 42-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital for evaluation of severe thrombocytopenia. She was treated with steroids, intravenous cyclophosphamide, intravenous immunoglobulin, and plasma exchange, but her thrombocytopenia did not improve. Renal biopsy showed class IV-S(C) + V lupus nephritis, according to the classification of the International Society of Nephrology/Renal Pathology Society. The PA-IgG and serum thrombopoietin (TPO) levels were elevated. Her thrombocytopenia responded to off-label administration of eltrombopag, which was discontinued after 42 months. At 18 months after stopping eltrombopag, the platelet count was 19.3 × 10 4 / μ L. Eltrombopag may be a therapeutic option for SLE patients with severe thrombocytopenia refractory to conventional therapy.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Systemic Lupus Erythematosus Presenting with Alveolar Hemorrhage  

    Tolaymat, Omar (Mayo Clinic Florida, Department of Rheumatology, 4500 San Pablo Road, Jacksonville, FL 32224, USA ) , Berianu, Florentina (Mayo Clinic Florida, Department of Rheumatology, 4500 San Pablo Road, Jacksonville, FL 32224, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 3 , 2018 , 2090-6889 ,

    초록

    Introduction . Diffuse alveolar hemorrhage is a rare presentation of systemic lupus erythematosus. Early diagnosis and appropriate treatment can improve outcome. Case Report . An 18-year-old male presented with hemoptysis and respiratory distress requiring orotracheal intubation. Laboratory tests showed positive anti-nuclear antibody and anti-dsDNA and low C3 and C4. Bronchoalveolar lavage became progressively hemorrhagic after each aliquot. He was treated with pulse methylprednisolone, cyclophosphamide, and plasma exchanges. Discussion . Alveolar hemorrhage is a rare initial presentation of lupus, with mortality rates reported at about 50%. Lupus should be considered in those presenting with alveolar hemorrhage since delay in therapy may cause a rapid deterioration of the patient. The diagnosis of SLE is illusive when DAH is the presenting symptom. Since early diagnosis and appropriate institution of treatment improve outcome, it is important to keep lupus in mind as an etiology of alveolar hemorrhage. Pulse methylprednisolone, cyclophosphamide, and plasmapheresis therapy resulted in rapid improvement of respiratory function in our patient.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   A Case of Multiple Myeloma Misdiagnosed as Seronegative Rheumatoid Arthritis and Review of Relevant Literature  

    Schoninger, Scott (College of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA ) , Homsi, Yamen (Division of Rheumatology, SUNY Downstate Medical Center, 450 Clarkson Avenue Box 42, Brooklyn, NY 11203, USA ) , Kreps, Alexandra (Division of Rheumatology, SUNY Downstate Medical Center, 450 Clarkson Avenue Box 42, Brooklyn, NY 11203, USA ) , Milojkvovic, Natasa (Division of Hematology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA)
    Case reports in rheumatology v.2018 ,pp. 1 - 5 , 2018 , 2090-6889 ,

    초록

    Multiple myeloma (MM) is a malignant plasma cell proliferation producing large numbers of monoclonal immunoglobulins. Typical MM symptoms include anemia, renal failure, hypercalcemia, and bone pain. Atypical symptoms have rarely been reported in the literature. We report a case of a 58-year-old male who presented with symmetrical inflammatory polyarthritis and was misdiagnosed with seronegative rheumatoid arthritis (RA). After failing many RA treatments and with further workup, the diagnosis of MM was made. This rare manifestation of MM carries a diagnostic challenge and causes a significant delay in treating such patients. Here, we report this unusual initial presentation with review of several cases in the English literature describing similar presentations.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  10. [해외논문]   IgG4-Related Disease, the Malignancy Mimicker: Case Series from Bahrain  

    Haider, Majeed (Chief Resident, Rheumatology Unit, Salmaniya Medical Hospital, Manama, Bahrain ) , Haji, Fatima (Consultant Rheumatologist, Rheumatology Unit, Salmaniya Medical Hospital, Manama, Bahrain ) , Alalwan, Osama (Chief Resident, Rheumatology Unit, Salmaniya Medical Hospital, Manama, Bahrain ) , Aljufairi, Eman (Consultant Pathologist, Pathology Unit, Salmaniya Medical Hospital, Manama, Bahrain ) , Shah, Tejal S. (Consultant Diagnostic Radiologist, Radiology Unit, Salmaniya Medical Hospital, Manama, Bahrain)
    Case reports in rheumatology v.2018 ,pp. 1 - 9 , 2018 , 2090-6889 ,

    초록

    IgG4-related disease is an evolving immune-mediated condition. The hallmark of this condition is IgG4(+) plasma cells infiltration of the affected organs accompanied by a variable degree of fibrosis and occasionally elevated serum IgG4 level. It links many conditions that were once recognized as isolated unrelated idiopathic single organ disorders (e.g., autoimmune pancreatitis, Mikulicz syndrome, and retroperitoneal fibrosis) under one umbrella. It usually presents clinically as tumor-like swelling of the involved organs that can be misdiagnosed as neoplasia. In this case series, we present four cases that were considered as neoplasia but turned out to be IgG4-related disease, we demonstrate the protean manifestations of this condition and variable organs involvement, and we share our experience in using rituximab as the steroid sparing immunosuppressant agent to control this disease.

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