1. Clinical and imaging features of IgG4-related kidney disease
- Author
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Jian Ling, Shurong Li, Weibin Pan, Xiaoling Zhang, Yan Guo, Jian Guan, and Huanjun Wang
- Subjects
medicine.medical_specialty ,Contrast enhancement ,Urology ,Disease ,Malignancy ,Kidney ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Magnetic resonance imaging ,Hepatology ,medicine.disease ,Kidney Neoplasms ,030220 oncology & carcinogenesis ,Kidney Diseases ,Radiology ,Immunoglobulin G4-Related Disease ,medicine.symptom ,business ,Tomography, X-Ray Computed ,Kidney disease ,Hormone - Abstract
To assess the clinical and imaging features of IgG4-RKD for understanding and diagnosis of this disease. CT and MR images of 34 patients with IgG4-RKD were retrospectively analyzed by two radiologists in consensus. The serum IgG4 level was found being increased in all patients. Renal involvement was bilateral (24/34, 70.6%) or unilateral (10/34,29.4%), multiple (29/34, 85.3%) or solitary (5/34, 14.7%). The lesions were wedge-shaped (21) or mass-like (4) in the renal parenchyma, whereas diffusely decreased renal density was noted in 2 patients. All lesions showed progressive contrast enhancement. The 4 mass-like lesions were misdiagnosed as renal malignancy. In 15 patients with follow-up imaging examinations, the number and size of renal lesions decreased after oral hormone treatment. The serum IgG4 levels were significantly decreased after therapy in all patients. IgG4-RKD has various imaging appearances. Although the mass-like appearance mimics renal malignancy in some patients, progressive contrast enhancement in the lesion with elevated serum IgG4 suggests IgG4-RKD.
- Published
- 2020