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[JAMA诊断检查解读]:免疫球蛋白G4水平(问题)
2019年02月03日 临床话题, 模拟诊室 暂无评论

JAMA Diagnostic Test Interpretation January 15, 2019

Immunoglobulin G4 Levels

Sajan Jiv Singh Nagpal, Suresh T. Chari

JAMA. 2019;321(2):202-203. doi:10.1001/jama.2018.16665Case

A 67-year-old man with type 2 diabetes mellitus and hyperlipidemia was evaluated for unintentional weight loss of 28 lb (12.7 kg) and increasing fasting blood glucose values over the past 6 months. A computed tomography scan showed diffuse enlargement of the pancreas with peripheral hypoenhancement but no discrete mass. Soft tissue surrounded the infrarenal abdominal aorta, extended along the common iliac arteries, and obstructed the left ureter, causing hydronephrosis. He was referred for evaluation of possible malignancy. Laboratory studies including immunoglobulin G subgroup 4 (IgG4) levels are shown in the Table. Fine-needle aspiration of the pancreas showed no malignancy. Colonoscopy results 8 months ago were normal.

一名67岁2型糖尿病及高脂血症的男性患者在6个月内体重下降12.7 kg,空腹血糖水平升高。CT扫描显示胰腺弥漫性增大,周围呈低密度,但未发现肿物。软组织包绕肾下腹主动脉,并沿髂总动脉延伸,阻塞左侧输尿管导致肾盂积水。患者接受了肿瘤相关筛查。包括免疫球蛋白G亚组4 (IgG4)在内的实验室检查见下表。胰腺细针穿刺未发现恶性肿瘤。8个月前的结肠镜结果正常。

Patient’s Laboratory Values and Reference Ranges 患者实验室检查结果及参考值

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