The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2009;77(2):484-488.
항 면역글로불린 G4 염색 양성을 보이는 Mikulicz병 1예와 초음파 소견
김영욱, 권성렬, 주영채, 임미진, 김보묵, 박 원
A case of Mikulicz’s disease with positive anti-immunoglobulin G4 staining and unique ultrasonographic findings
Young Wook Kim, Seong Ryul Kwon, Young Chae Chu, Mie Jin Lim, Bo Mook Kim, Won Park


Abstract
Mikulicz’s disease is an immunoglobulin G4-related systemic disease involving enlargement of the lacrimal and salivary glands that differs substantially from Sjögren’s syndrome. A 45-year-old woman who noticed bilateral swelling in the submandibular region and dry mouth for 6 months was admitted. Ultrasonography of the enlarged glands revealed an irregular, hypoechoic, multilobular mass, and the power Doppler showed that the mass was hypervascular. She had an elevated immunoglobulin G level, positive Schirmer’s I test, and positive unstimulated whole salivary flow test, but was negative for antinuclear, anti-Ro/SS-A, and anti-La/SS-B antibodies. The submandibular gland biopsy showed diffuse infiltration of lymphocytes and plasma cells expressing immunoglobulin G4. We report a patient diagnosed with Mikulicz’s disease involving the infiltration of plasma cells expressing immunoglobulin G4 and unique ultrasonographic findings.

Keywords :Mikulicz’s disease, Immunoglobulin G4, Ultrasonography
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