Case Series

Immunoglobulin G4 disease-related retroperitoneal fibrosis: A series of five cases

Mohd Ilyas, Shwait Sharma, Vikrant Gupta
South African Journal of Radiology | Vol 28, No 1 | a2830 | DOI: https://doi.org/10.4102/sajr.v28i1.2830 | © 2024 Mohd Ilyas, Shwait Sharma, Vikrant Gupta | This work is licensed under CC Attribution 4.0
Submitted: 06 December 2023 | Published: 13 May 2024

About the author(s)

Mohd Ilyas, Department of Radiology, Aster Hospital, Sharjah, United Arab Emirates
Shwait Sharma, Department of Radiology, Government Medical College, Jammu, India
Vikrant Gupta, Department of Radiology, Government Medical College, Jammu, India

Abstract

Immunoglobulin G4 (IgG4)-related disease has the potential to impact any part of the body, including the walls of large- and medium-sized blood vessels and the ureters. While histopathologic examination is currently the standard method for identifying organ involvement and diagnosing IgG4-related disease (IgG4-RD), obtaining biopsy or surgical samples from vessel or ureteral walls is challenging. Given that patients may display only mild symptoms, non-invasive imaging plays a vital role in both diagnosing and managing IgG4-related diseases. Multidetector CT scans are valuable in establishing the primary diagnosis, identifying anatomical landmarks and assessing their relationships. Involvement of the genitourinary organs, such as the ureter, bladder, urethra, and male and female reproductive organs in IgG4-RD, is infrequent when compared to kidney involvement. The imaging findings may include the presence of a localised mass within or surrounding the affected organ or a generalised enlargement of the organ. This report includes cross-sectional images of five cases of IgG4-RD involving large- and medium-sized blood vessels (the aorta and superior mesenteric artery) and the ureters.

Contribution: This case series provides insight into the various imaging appearances of IgG4-related retroperitoneal organ involvement and helps differentiate it radiologically from retroperitoneal fibrosis.


Keywords

immunoglobulin G4-related disease; CT; MRI; retroperitoneal fibrosis; aorta; ureter

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