A Diagnostic Paradox: Identifying IgG4-Related Disease in a Patient Previously Diagnosed with Sjogren’s Syndrome

Author:

Lee Ju Young1,Reichl Allison2ORCID,O'Brien Courtney2,Ayoub Michael2ORCID

Affiliation:

1. David Geffen School of Medicine at University of California, Los Angeles

2. UCLA Medical Center

Abstract

We present the case of a 77-year-old male with a history of rectal adenocarcinoma and Sjogren’s disease who was admitted for severely elevated liver function tests. Cross-sectional imaging demonstrated a dilated bile duct, and eventual biopsy of the area showed fibrosis and lymphocytic infiltrate consistent with IgG4-related disease. The patient was treated with rituximab and a prednisone taper. This case discusses the clinical, laboratory, and imaging hallmarks of this rare disease and illustrates the practical challenges of distinguishing it from other rheumatologic conditions.

Publisher

Department of Medicine, Warren Alpert Medical School at Brown University

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