IgG4-related thyroiditis

IgG4-related disease is now considered a systemic disease that might affect every organ with progressively growing fibroinflammatory lesions causing a mass effect. Its diagnosis is based on a typical histology, high count of IgG4-positive plasma cells per high-power field (HPF), and high IgG4/IgG ratio.

Salook et al. report  on a 55-year old male with a positive medical history of hypothyroidism treated  with L-thyroxin  for several years. Due to an enlarging goiter and exacerbation in the patient’s complaints, he was operated with excision of a fibrotic and enlarged thyroifd lobe. Elevated IgG4 plasma levels and high IgG4/IgG plasma cell ratio on immunohistochemistry led to the diagnosis of IgG4-mediated thyroiditis. The authors recommend that IgG4-thyroiditis and IgG4-related disease should be considered in all patients with an aggressive form of Hashimoto's thyroiditis.

Read full case report at Salook et al. (2014) Endocrinology, Diabetes, Metabolism Case Reports DOI: 10.1530/EDM-14-0037.