Immunoglobulin G4-related Dacryoadenitis Successfully Treated with Baricitinib

Atsuhiko Suenaga; Naoki Sawa; Yuki Oba; Daisuke Ikuma; Akinari Sekine; Masayuki Yamanouchi; Eiko Hasegawa; Hiroki Mizuno; Tatsuya Suwabe; Hideki Tsuji; Kei Kono; Keiichi Kinowaki; Motoaki Miyazono; Yutaka Yamaguchi; Yoshifumi Ubara

doi:10.2169/internalmedicine.1862-23

CASE REPORTS

Immunoglobulin G4-related Dacryoadenitis Successfully Treated with Baricitinib

Atsuhiko Suenaga, Naoki Sawa, Yuki Oba, Daisuke Ikuma, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Hiroki Mizuno, Tatsuya Suwabe, Hideki Tsuji, Kei Kono, Keiichi Kinowaki, Motoaki Miyazono, Yutaka Yamaguchi, Yoshifumi Ubara

Author information

Atsuhiko Suenaga
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Department of Nephrology, Saga University Internal Medicine, Japan
Naoki Sawa
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Yuki Oba
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Daisuke Ikuma
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Akinari Sekine
Department of Nephrology and Rheumatology, Toranomon Hospital, Japan
Masayuki Yamanouchi
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Eiko Hasegawa
Department of Nephrology, Saga University Internal Medicine, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Hiroki Mizuno
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Tatsuya Suwabe
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Hideki Tsuji
Department of Ophthalmology, the Cancer Institute Hospital of JFCR, Japan
Kei Kono
Department of Pathology, Toranomon Hospital, Japan
Keiichi Kinowaki
Department of Pathology, Toranomon Hospital, Japan
Motoaki Miyazono
Department of Nephrology, Saga University Internal Medicine, Japan
Yutaka Yamaguchi
Yamaguchi's Pathology Laboratory, Japan
Yoshifumi Ubara
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan

Keywords: IgG4-related dacryoadenitis, baricitinib, IgG4 related disease, atopic dermatitis

JOURNAL OPEN ACCESS

2024 Volume 63 Issue 3 Pages 461-464

DOI https://doi.org/10.2169/internalmedicine.1862-23

Details

Abstract

A 48-year-old woman visited our hospital because of bilateral lacrimal gland enlargement. Her serum immunoglobulin G4 (IgG4) level was high, and positron emission tomography-computed tomography showed significant positive findings in the bilateral lacrimal gland. A biopsy revealed a considerable increase in IgG4/CD138, leading to a diagnosis of IgG4-related dacryoadenitis. The disease did not respond to steroid therapy, so treatment was started with baricitinib because of exacerbation of the original atopic dermatitis and dacryoadenitis after the second dose of the coronavirus disease 2019 (COVID-19) vaccine. Baricitinib was effective for resolving both dermatitis and dacryoadenitis, and steroids were able to be discontinued. The IgG4 level also improved.

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