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Lee SH, Jaafar R, Misron NA, Yusof Z. IgG4-Related Disease of the Pharynx with Spontaneous Regression. Am J Med 2022; 135:e420-e422. [PMID: 35817139 DOI: 10.1016/j.amjmed.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Shen-Han Lee
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia.
| | - Rohaizam Jaafar
- Department of Otorhinolaryngology, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Akmar Misron
- Department of Pathology, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Zulkifli Yusof
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
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Barańska M, Makowska J, Wągrowska-Danilewicz M, Pietruszewska W. Supraglottic Localization of IgG4-Related Disease—Rare and Challenging Equity. J Pers Med 2022; 12:jpm12081223. [PMID: 36013172 PMCID: PMC9409927 DOI: 10.3390/jpm12081223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/12/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Supraglottic stenosis is a rare symptom, particularly in fibroinflammatory multifocal diseases, such as IgG4-related disease (IgG4-RD). There is still an inconsistency in the diagnosis of less-common locations of IgG4-RD, which causes a delay in the diagnosis and treatment. Our paper aims to analyze different aspects of IgG4-RD presenting as supraglottic stenosis, including the possible overlap with ANCA-associated vasculitis. We compare the usefulness of the recently revised ACR/EULAR and Comprehensive criteria and discuss treatment options. The review was performed according to PRISMA guidelines using the MEDLINE Pubmed and Scopus databases. The analysis includes nine papers describing supraglottic laryngeal stenosis in 13 patients. Furthermore, we present a case of a woman with ongoing supraglottic stenosis presenting with cough, temporary dyspnea and stridor as the symptoms of localized IgG4-RD. At the time of writing, the patient remains in remission while receiving treatment with cyclophosphamide and methylprednisolone. The symptoms of supraglottic localization of IgG4-RD may be severe; however, at that point, clinicians should suspect autoimmune etiology and attempt to modulate the autoimmune response instead of performing dilatation surgery—the effects of which may not result in extended intervals between interventions. The ACR/EULAR criteria show great specificity; however, when IgG4-RD is presumed, the specific treatment should be implemented.
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Affiliation(s)
- Magda Barańska
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland;
- Correspondence:
| | - Joanna Makowska
- Department of Rheumatology, Medical University of Lodz, 90-419 Lodz, Poland;
| | | | - Wioletta Pietruszewska
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland;
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Nallani P, Guo W, Mayerhoff RM, Meysami A. An Unusual Presentation of Immunoglobulin G4-Related Disease (IgG4-RD) Causing Subglottic Stenosis. Cureus 2022; 14:e26250. [PMID: 35911268 PMCID: PMC9313090 DOI: 10.7759/cureus.26250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/09/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that is known to involve multiple organs and was first described as an entity in 2003. It is characterized by lesions with a dense lymphoplasmacytic infiltrate, IgG4-positive plasma cells, storiform fibrosis, and frequently elevated serum IgG4 levels. Organs that are commonly involved include the pancreas, biliary tree, salivary glands, periorbital tissues, kidneys, retroperitoneum, lungs, pleura, thyroid, aorta, and lymph nodes. Rarer manifestations of IgG4-RD include central nervous system (CNS) involvement, prostatitis, mastitis, midline destructive disease, and nasopharyngeal disease. In this report, we discuss an atypical case of a young woman with laryngeal subglottic involvement leading to stenosis and airway obstruction, which was ultimately successfully managed with systemic immunosuppression.
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Yang L, Li W. Giant inflammatory myofibroblastic tumor of the hypopharynx: an unusual cause of acute upper airway obstruction in a 6-year-old child. WORLD JOURNAL OF PEDIATRIC SURGERY 2022; 5:e000342. [DOI: 10.1136/wjps-2021-000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/19/2022] [Indexed: 11/03/2022] Open
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Atienza-Mateo B, Díaz de Terán-López T, Gómez-Román J, Sánchez L, Mons-Lera R, Rubio-Suárez A, Cifrián JM, González-Gay MÁ. Atypical presentation of immunoglobulin G4-related disease as subglottic stenosis: a case-based review. Rheumatol Int 2021; 41:1161-1167. [PMID: 33834281 PMCID: PMC8079302 DOI: 10.1007/s00296-021-04816-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/16/2021] [Indexed: 12/02/2022]
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized fibro-inflammatory pathology that has been reported to affect principally the retroperitoneum, hepatobiliary system, salivary glands, orbital structures or lymph nodes. However, IgG4-RD with laryngeal involvement is a very rare entity. Our aims were to describe a case of subglottic stenosis as first and only manifestation of IgG4-RD and review the literature. A patient with IgG4-RD affecting the larynx that presented as subglottic stenosis is described. A MEDLINE database search of IgG4-RD cases with laryngopharyngeal manifestations was also conducted. A 30-year-old Caucasian woman was referred to a tertiary care hospital for dyspnea on exertion, which had been increasing for the last 4 months. Medical and surgical procedures revealed a subglottic stenosis, with a histological finding of IgG4 positive plasma cell infiltration. There was no evidence of other organ involvement. She was successfully treated with oral glucocorticoids and rituximab infusions. Glucocorticoids were rapidly tapered and the rituximab regimen was optimized, with no evidence of relapses. In the literature review, we found a total of 12 reported cases with laryngopharyngeal involvement, two of them with subglottic stenosis. IgG4-RD of the larynx is rare but should be considered after excluding more common disorders.
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Affiliation(s)
- Belén Atienza-Mateo
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain.,Epidemiology, Genetics and Atherosclerosis Research Group On Systemic Inflammatory Diseases, IDIVAL, Santander, Spain
| | | | - Javier Gómez-Román
- Division of Pathology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | - Laura Sánchez
- Division of Thoracic Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Roberto Mons-Lera
- Division of Thoracic Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Antonio Rubio-Suárez
- Division of Otorhinolaryngology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - José Manuel Cifrián
- Epidemiology, Genetics and Atherosclerosis Research Group On Systemic Inflammatory Diseases, IDIVAL, Santander, Spain.,Division of Pulmonology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | - Miguel Á González-Gay
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain. .,Epidemiology, Genetics and Atherosclerosis Research Group On Systemic Inflammatory Diseases, IDIVAL, Santander, Spain. .,University of Cantabria - IDIVAL, Santander, Spain. .,Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Lin R, Wang S, Lin J, Zhang Z, Chen X. Cross-segment spinal plasma cell granuloma:a case report. BMC Musculoskelet Disord 2020; 21:746. [PMID: 33183250 PMCID: PMC7663890 DOI: 10.1186/s12891-020-03759-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasma cell granuloma (PCG) is a rare non-neoplastic entity, with the precise etiology remaining unclear. Vertebra-affected spinal PCG has not been reported yet. This report presented a case with cross-segment spinal PCG in thoracolumbar region. CASE PRESENTATION A 32-year-old male patient presented to the authors' hospital since his health check-up results showed osteolytic lesions in the thoracolumbar spine. He felt asymptomatic throughout the course. Radiological examination revealed destructive changes at T12 and L1 vertebrae. Whereas laboratory examination excluded malignant tumor. The results of routine incisional biopsy remained inconclusive, thereby necessitating complete excision of the lesions. Finally, the infiltration of plasma cells observed by pathological examination of the surgical specimen confirmed the diagnosis of PCG. CONCLUSIONS To the authors' knowledge, this was the first case of cross-segment spinal PCG with osteolytic property. The possibility of PCG should be considered for the diagnosis and differential diagnosis of an osteolytic lesion in the spine. Since the etiology of PCG is unknown, the disorder was confirmed based on excluded diagnosis. Surgical resection is recommended both for the definite diagnosis and treatment of spinal PCG.
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Affiliation(s)
- Renqin Lin
- Department of Orthopedic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, P.R. China
| | - Shenglin Wang
- Department of Orthopedic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, P.R. China
| | - Jianhua Lin
- Department of Orthopedic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, P.R. China
| | - Zhenzhen Zhang
- Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, P.R. China
| | - Xuanwei Chen
- Department of Orthopedic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, P.R. China.
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Maughan EF, Michaels J, Miller B, Weir J, Salama A, Warner E, Ghufoor K, Sandhu G, Al Yaghchi C. Primary Immunoglobulin G4-Related Laryngeal Disease: A Case Series and Review of Literature. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2020; 13:1179547620960197. [PMID: 33192112 PMCID: PMC7597568 DOI: 10.1177/1179547620960197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023]
Abstract
Objective: Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognised cause of various systemic fibro-inflammatory conditions. However, laryngeal involvement as a primary feature is extremely rare. We aimed to report on a case series of such patients and examine the global literature relating to laryngeal involvement. Methods: Having previously reported a case of IgG4-RD laryngeal pseudotumour, we describe a case series of further 4 patients with primary laryngeal IgG4-RD managed by our UK quaternary airway service and provide a brief overview of laryngeal IgG4-RD. Results: Including our cases, 14 cases of primary laryngeal IgG4-RD have been reported. Vocal cord involvement is relatively uncommon. Repeat biopsies may be required to achieve histological diagnosis. Remission is achievable by commencement of immunomodulatory treatment, following which laryngeal reconstruction may be necessary. Conclusion: Laryngeal involvement is a rare presentation of IgG4-RD, itself a rare and difficult-to-diagnose condition. A high and prolonged index of suspicion is necessary from both surgical and pathological specialists for correct diagnosis and management.
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Affiliation(s)
- Elizabeth F Maughan
- Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
| | - Joshua Michaels
- Department of Otolaryngology, Barts Health NHS Trust, London, UK
| | - Benjamin Miller
- Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
| | - Justin Weir
- Department of Pathology, Imperial College Healthcare NHS Trust, London, UK
| | - Alan Salama
- Department of Nephrology, Royal Free London NHS Foundation Trust, London, UK
| | - Elinor Warner
- Department of Otolaryngology, Barts Health NHS Trust, London, UK
| | - Khalid Ghufoor
- Department of Otolaryngology, Barts Health NHS Trust, London, UK
| | - Gurpreet Sandhu
- Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
| | - Chadwan Al Yaghchi
- Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
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Goyal A, Rathore M, Singh SK, Nada R. Generalised gingival enlargement as a sole manifestation of IgG4-related disease. BMJ Case Rep 2020; 13:13/7/e236338. [PMID: 32675130 DOI: 10.1136/bcr-2020-236338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An 18-year-old woman presented with enlarged gingivae of 1-year duration with no history of drug consumption or systemic conditions that might explain the enlargement. Biopsy revealed hyperplastic gingival epithelium and a plasma cell-rich inflammatory infiltrate in the subepithelial connective tissue with the presence of scattered multinucleated giant cells. Immunostaining revealed the plasma cells to be positive for IgG4. Serum IgG4 levels were elevated at 3.6 g/L (reference range: 0.049-1.985). These findings led towards the diagnosis of an IgG4-related disease (RD). Other granulomatous conditions were also ruled out via series of investigations. The enlarged tissue was surgically excised. No corticosteroids were administered owing to the localised nature of the manifestations. After 3 months, the gingival size remained unchanged. This case has been reported with a relatively shorter follow-up period because of the rarity of the presentation. IgG4-RD should be considered while diagnosing a patient with gingival enlargement.
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Affiliation(s)
- Ashima Goyal
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mrinalini Rathore
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Kumar Singh
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambara Nada
- Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Infrequent organ involvement of IgG4-related diseases: a literature review. Clin Rheumatol 2018; 37:1153-1159. [PMID: 29502226 DOI: 10.1007/s10067-018-4048-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/30/2018] [Accepted: 02/19/2018] [Indexed: 01/28/2023]
Abstract
IgG4-related disease (IgG4-RD) is a chronic and systemic disease that can involve multiple organs. The most commonly involved organs include the salivary glands, orbital adnexal structures, paranasal sinus, thyroid, lungs, breasts, aorta, pancreas, biliary ducts, kidneys, retroperitoneum, lymph nodes, prostate, pituitary, and endocranium. Due to increased disease research, several new site-specific nuances of IgG4-RD have been described. The authors have reviewed the recent literature and briefly summarize the infrequent organ involvement of IgG4-RD.
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Hamadani S, Wang B, Gupta S. IgG4-related disease presenting as hoarseness and postcricoid ulcer. Ann Allergy Asthma Immunol 2017; 120:211-212. [PMID: 29217085 DOI: 10.1016/j.anai.2017.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/21/2017] [Accepted: 10/25/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Syeda Hamadani
- Division of Basic and Clinical Immunology, University of California, Irvine, Irvine, California
| | - Beverly Wang
- Department of Pathology & Laboratory Medicine, University of California, Irvine, Irvine, California
| | - Sudhir Gupta
- Division of Basic and Clinical Immunology, University of California, Irvine, Irvine, California.
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Recent advances in knowledge regarding the head and neck manifestations of IgG4-related disease. Auris Nasus Larynx 2016; 44:7-17. [PMID: 27956101 DOI: 10.1016/j.anl.2016.10.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/31/2016] [Indexed: 12/24/2022]
Abstract
IgG4-related disease (IgG4-RD) is a chronic inflammatory disorder, characterized by elevated serum IgG4 levels as well as abundant infiltration of IgG4-positive plasmacytes and fibrosis in various organs, including the head and neck region. In particular, the salivary glands, orbit, and thyroid are common sites of disease involvement. IgG4-RD is diagnosed based on various clinical, serological, and histopathological findings, none of which are pathognomonic. Hence, various differential diagnoses, which exhibit elevated serum IgG4 levels and infiltration of IgG4-postive cells into tissues, need to be excluded, especially malignant diseases and mimicking disorders. Systemic corticosteroids are generally effective in inducing IgG4-RD remission; however, recurrent or refractory cases are common. In addition, although the pathogenic mechanisms of IgG4-RD remain unclear, an antigen-driven inflammatory condition is believed to be involved. Recent studies have indicated the important pathogenic role of B cell/T cell collaboration and innate immunity in this disease. Nevertheless, additional research and discussions are needed to resolve many remaining questions. In this review, we provide an overview of the recent insights on the history, clinical features, diagnosis, and treatment of IgG4-RD in the head and neck region. Furthermore, we have also addressed the pathogenesis of this disease.
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Chougule A, Bal A. IgG4-related inflammatory pseudotumor: A systematic review of histopathological features of reported cases. Mod Rheumatol 2016; 27:320-325. [PMID: 27416329 DOI: 10.1080/14397595.2016.1206241] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES There is marked inconsistency in reporting the key features of IgG4-related inflammatory pseudotumor (IPT) cases. We aimed to analyze the various aspects of IgG4-related IPTs and to test the performance of the consensus criteria for their diagnosis. METHODS PubMed database was searched for IgG4-related IPT cases. The data regarding patient demographics, clinical presentation, laboratory findings, histopathological features, and treatment response are extracted and are presented here in a descriptive manner. RESULTS The study included 40 papers describing the clinicopathological features of 83 IPTs in 80 patients. Seventeen cases were diagnosed on biopsies; while remaining were diagnosed on excision specimens. Among these, 50 cases were categorized as highly suggestive and 24 cases as probable for IgG4RD; while nine cases had insufficient histopathological evidence of IgG4RD. Two cases diagnosed on biopsies having insufficient evidence of IgG4RD showed partial or no response to steroids; while 12/14 cases (85.71%) diagnosed on biopsies that were histologically suggestive or probable for IgG4RD showed prompt response to steroids. CONCLUSION Many reports have not specifically mentioned the full histopathological findings of IgG4-related IPTs that may hinder in refining the diagnostic criteria of IgG4RD. The IgG4-related IPTs diagnosed on biopsies with requisite features showed prompt response to steroids indicating specificity of histopathological findings in predicting treatment response.
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Affiliation(s)
- Abhijit Chougule
- a Department of Histopathology , Post Graduate Institute of Medical Education and Research, (PGIMER) , Sector 12 , Chandigarh , India
| | - Amanjit Bal
- a Department of Histopathology , Post Graduate Institute of Medical Education and Research, (PGIMER) , Sector 12 , Chandigarh , India
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Laco J, Kamarádová K, Mottl R, Mottlová A, Doležalová H, Tuček L, Žatečková K, Slezák R, Ryška A. Plasma cell granuloma of the oral cavity: a mucosal manifestation of immunoglobulin G4-related disease or a mimic? Virchows Arch 2014; 466:255-63. [PMID: 25522952 DOI: 10.1007/s00428-014-1711-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/23/2014] [Accepted: 12/09/2014] [Indexed: 12/23/2022]
Abstract
The aim of the study was to test the hypothesis that oral plasma cell granuloma may represent a mucosal manifestation of immunoglobulin (Ig)G4-related disease (IgG4-RD) in the oral cavity. The study sample comprised two males and four females, aged 54-79 years (median 62 years). The lesions were localized on gingival/alveolar mucosa (four cases), hard palate, and floor of the mouth, measuring 17-40 mm (median 31 mm). The duration of the lesions ranged from 3 months to several years. Information on IgG4 serum levels was available for two patients, and these were increased to 1.85 and 1.65 g/L, respectively. The follow-up period ranged 11-30 months (median 13 months). None of the lesions recurred, and none of the patients developed any manifestation of IgG4-RD. Microscopically, all cases presented as nodular lesions composed of numerous polyclonal plasma cells admixed with lymphocytes, histiocytes, mast cells, and eosinophils, set within collagenized stroma in variable proportions. Obliterative phlebitis was observed in two cases. The number of IgG4-positive plasma cells ranged between 51 and 142 per HPF (median 114), while the IgG4/IgG ratio values ranged between 0.16 and 0.72 (median 0.44) and were above 0.40 in three cases. Based on international criteria, two cases were diagnosed as definite and one as probable IgG4-RD. Oral plasma cell granuloma is a heterogeneous group of lesions, and a subset may represent a mucosal manifestation of IgG4-RD in the oral cavity.
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Affiliation(s)
- Jan Laco
- The Fingerland Department of Pathology, Charles University in Prague-Faculty of Medicine and University Hospital in Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic,
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Abstract
Objective: The objective of this report is to characterize IgG4-related disease (IgG4-RD) as it is manifested in the head and neck and describe a series of patients with a rarely described presentation in laryngopharyngeal subsites. Methods: Here, we illustrate the presentation and clinical course of 3 patients with laryngopharyngeal manifestations of IgG4-RD, including the manner of diagnosis and effective treatment. Results: Three patients with laryngopharyngeal lesions were ultimately diagnosed with IgG4-RD after lengthy work-up. The diagnostic criteria and treatment protocols are explained. Conclusion: IgG4-related disease is a fibroinflammatory disorder now described in almost every organ system. The head and neck regions are among the most common areas of involvement, however, reports of laryngopharyngeal involvement are rare. We also summarize current knowledge of this entity and discuss established diagnostic criteria and clinical findings.
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