Abstract |
Sclerosing mesenteritis is a rare inflammatory and fibrosing disorder of unknown etiology, while IgG4-related disease (IgG4-RD) consists of mass-forming, fibroinflammatory lesions characterized by high serum IgG4 levels and tissue infiltration of many IgG4-positive plasma cells; obliterative phlebitis is common. This report describes a case of sclerosing mesenteritis that was considered a manifestation of IgG4-RD. A 53-year-old man underwent right hemicolectomy because of an ileocecal mass that did not improve with conservative therapy. The ill-defined fibroinflammatory lesion extended in the mesentery with storiform fibrosis, obliterative phlebitis, and infiltration of many IgG4-positive plasma cells. The ratio of IgG4-positive/ IgG-positive cells was 64%, and the ratio of forkhead box protein 3 (FOXP3)-positive/CD4-positive cells was elevated (13%). It is likely that at least some cases of sclerosing mesenteritis are a manifestation of IgG4-RD. It is important to investigate this relationship because steroid therapy may benefit such cases.
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Authors | Hiroshi Minato, Junzo Shimizu, Yoshihiko Arano, Kenichiro Saito, Takaharu Masunaga, Toshiki Sakashita, Takayuki Nojima |
Journal | Pathology international
(Pathol Int)
Vol. 62
Issue 4
Pg. 281-6
(Apr 2012)
ISSN: 1440-1827 [Electronic] Australia |
PMID | 22449233
(Publication Type: Case Reports, Journal Article)
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Copyright | © 2012 The Authors. Pathology International © 2012 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd. |
Chemical References |
- Anti-Bacterial Agents
- Biomarkers
- CD4 Antigens
- FOXP3 protein, human
- Forkhead Transcription Factors
- Immunoglobulin G
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Topics |
- Anti-Bacterial Agents
(therapeutic use)
- Biomarkers
(metabolism)
- CD4 Antigens
(metabolism)
- Cecum
(pathology, surgery)
- Colectomy
- Forkhead Transcription Factors
(metabolism)
- Humans
- Ileum
(pathology, surgery)
- Immunoglobulin G
(metabolism)
- Intestinal Neoplasms
(diagnosis, surgery)
- Male
- Mesentery
(pathology, surgery)
- Middle Aged
- Panniculitis, Peritoneal
(diagnosis, metabolism, therapy)
- Plasma Cells
(metabolism, pathology)
- Treatment Outcome
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