Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2022; 14(10): 1169-1178
Published online Oct 27, 2022. doi: 10.4240/wjgs.v14.i10.1169
Immunoglobulin G4-related disease in the sigmoid colon in patient with severe colonic fibrosis and obstruction: A case report
Wen-Li Zhan, Liang Liu, Wei Jiang, Fang-Xun He, Hai-Tao Qu, Zhi-Xin Cao, Xiang-Shang Xu
Wen-Li Zhan, Liang Liu, Wei Jiang, Fang-Xun He, Zhi-Xin Cao, Xiang-Shang Xu, Department of Gastrointestinal Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Hai-Tao Qu, Anorectal Disease Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
Author contributions: Zhan WL and Xu XS contributed to conceptualization, data curation, formal analysis, investigation, and methodology; Zhan WL, Liu L, and Jiang W contributed to visualization, roles/writing-original draft, and writing-review & editing; Cao ZX and Xu XS contributed to conceptualization, project administration, supervision, and writing - review & editing; Qu HT and He FX contributed to investigation; methodology and validation.
Supported by Tongji Hospital Foundation, No. 2021HGRY012; and The Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province, No. CXPJJH121003-2104.
Informed consent statement: Informed written consent was obtained from the patient and her family for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Shang Xu, MD, PhD, Associate Professor, Doctor, Department of Gastrointestinal Surgery, Tongji Hospital, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. xsxu@tjh.tjmu.edu.cn
Received: July 10, 2022
Peer-review started: July 10, 2022
First decision: August 19, 2022
Revised: September 3, 2022
Accepted: October 18, 2022
Article in press: October 18, 2022
Published online: October 27, 2022
Processing time: 107 Days and 6.6 Hours
Abstract
BACKGROUND

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated condition characterized by abundant IgG4 positive plasma cells and fibrosis in the affected tissues. It affects most parts of the body; however, there are not many reports on IgG4-RD involving the colon.

CASE SUMMARY

A 50-year-old man complaining of intermittent fever for more than two years was referred to our hospital. Based on various investigations before surgery, we diagnosed him with chronic perforation of the sigmoid colon caused by inflammatory change or tumor. IgG blood tests before the operation suggested IgG4-RD, and postoperative pathology confirmed this prediction.

CONCLUSION

We present a patient with IgG4-RD with colon involvement, which is an uncommon site. This report will expand the understanding of IgG4-RD in unknown tissues.

Keywords: Immunoglobulin G4-related disease; Chronic colon disease; Plasma cells; Fibrosis; Obstruction; Case report

Core Tip: Immunoglobulin G4-related disease (IgG4-RD) is characterized by abundant IgG4 positive plasma cells and fibrosis in the affected tissues. It can affect most parts of the body, but there were not many reports of IgG4-RD in the intestines. This patient was an IgG4-RD case to be reported in the colon, which was identified by computed tomography, magnetic resonance imaging, pathology and blood tests of IgGs. This case report will help expand the understanding of IgG4-RD in some unknown tissues.