Immunoglobulin G4-related constrictive pericarditis identified by cytological examination of pericardial effusion: a case report

摘要: Immunoglobulin G4-related disease is increasingly recognized as a systemic autoimmune disorder characterized by immunoglobulin G4-positive lymphocyte infiltration. Organ biopsy and histopathology are the most important diagnostic methods; however, significance of cytological examination in cases still unclear. A 73-year-old Asian man who was former tobacco smoker presented with progressive exertional dyspnea, edema, pericardial effusion. his effusion detected three or four plasma cells per high-power field Giemsa staining. Moreover, were immunostaining. Cardiac catheterization after pericardiocentesis revealed that both ventricular pressure traces showed an early diastolic dip plateau. Positron-emission tomography 18F-fluorodeoxyglucose imaging inflammatory foci pericardium. surgical pericardiectomy performed resultant specimen significant cell infiltration marked fibrous thickening pericardium; therefore, diagnosis constrictive pericarditis due to made. Oral administration 0.6-mg/kg/day prednisolone resolved heart failure he discharged on foot 1 week later. Our experience this case indicates useful disease.