IgG4-related Periarteritis Successfully Diagnosed by an Alternative Prostate Biopsy

Ryo Koda; Masafumi Tsuchida; Noriaki Iino; Masaki Murata; Kohei Inui; Yuki Nakagawa; Tsutomu Nishiyama; Yohei Ikeda; Go Hasegawa; Fumiaki Oguma; Ichiei Narita

doi:10.2169/internalmedicine.2723-19

CASE REPORTS

IgG4-related Periarteritis Successfully Diagnosed by an Alternative Prostate Biopsy

Ryo Koda, Masafumi Tsuchida, Noriaki Iino, Masaki Murata, Kohei Inui, Yuki Nakagawa, Tsutomu Nishiyama, Yohei Ikeda, Go Hasegawa, Fumiaki Oguma, Ichiei Narita

Author information

Ryo Koda
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Masafumi Tsuchida
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Noriaki Iino
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Masaki Murata
Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Kohei Inui
Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Yuki Nakagawa
Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Tsutomu Nishiyama
Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Yohei Ikeda
Department of Radiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Go Hasegawa
Department of Pathology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Fumiaki Oguma
Department of Cardiovascular Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Ichiei Narita
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, Japan

Keywords: IgG4-related disease, periarteritis, prostate biopsy, prostatitis

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 16 Pages 2401-2406

DOI https://doi.org/10.2169/internalmedicine.2723-19

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Abstract

A 56-year-old man was referred to our facility after developing edema in his right leg. Enhanced computed tomography (CT) revealed a periarterial soft tissue mass surrounding the right iliac artery compressing the iliac vein. His elevated serum IgG4 level indicated IgG4-related disease (IgG4-RD). Both a percutaneous and surgical biopsy of this periarterial lesion proved challenging and were not pursued. A prostate biopsy, however, finally provided a histological diagnosis of IgG4-RD. Oral steroid therapy successfully resolved his leg edema and periarterial lesion. This case illustrates the usefulness of an alternative prostate biopsy for the histological diagnosis of IgG4-RD when approaching the primary affected lesion is difficult.

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