Concurrent eosinophilia and IgG4‑related disease in a child: A case report and review of the literature
- Can Chen
- Kuang Chen
- Xilian Huang
- Kaile Wang
- Shenxian Qian
Published online on: January 12, 2018
Copyright: © Chen et al.
This is an open access article distributed under the terms of Creative Commons Attribution License.
The current study presents the case of a 9-year-old Chinese boy who presented with eosinophilia and elevated serum levels of immunoglobulin G4 (IgG4). A bone marrow puncture identified an elevated eosinophil rate of 23% (normal range, <5%), which indicated eosinophilia. However, gene analysis, fluorescent in situ hybridization and other examinations, including bone marrow aspiration, blood routine, auto‑antibody tests and parasitic and allergens screening, contradicted a diagnosis of secondary or clonal eosinophilia. Furthermore, the patient exhibited multiple lymph node swelling and a lymph biopsy strongly indicted a pathological diagnosis of IgG4‑related disease (IgG4‑RD). His peripheral blood flow cytometry confirmed an elevated count of plasmablasts, which is specific to IgG4‑RD. The patient responded well to therapy with prednisone and remained healthy in all follow‑ups. By taking all these factors into consideration, the boy was diagnosed with IgG4‑RD. It is difficult to distinguish IgG4‑RD from hypereosinophilic syndrome and the potential association between the two remains unclear. However, the present case study serves as a reminder that IgG4‑RD may occur in children and medical professionals should not neglect this possibility.