We report a case of male IgG4-related Mikulicz’s disease with chronic rhinosinusitis with high serum IgG4-and IgE-Immune Complex (IC). Untreated serum IgG4 was 3,110 mg/dL, while Polyethylene Glycol (PEG)-treated serum IgG4-IC was 1,460mg/dL. Both were markedly elevated (normal IgG4 range <105 mg/dL). Serum IgE and PEG-treated serum IgE-IC was also elevated (normal IgE range <170 IU/mL) at 376 IU/mL and 237 IU/mL, respectively. IgE PEG Precipitated (PP) index was higher than normal (<20%) at 63%. We speculate that serum IgG4 and IgE represented autoantibodies for a component of the paranasal sinus mucosa and submandibular gland tissue.
sIgG4 (mg/dL) | sIgE (Iµ/mL) | |
Total | 3110 | 420 |
Allergen | ||
Dermatophagoides pteronyssinus | 0.6282 | <0.10 |
Dermatophagoide farinae | 0.8504 | <0.10 |
House dust-Japan | 0.68 | <0.10 |
Japanese Cedar | 0.4749 | 0.479 |
Dog Dander | 0.4529 | <0.10 |
Aspergillus fumigatus | 0.5092 | <0.10 |
Mucor racemosus | 0.4332 | <0.10 |
Candida albicans | 0.5558 | <0.10 |
Alternaria tenuis | 0.4288 | <0.10 |
Malassezia furfur (pityrosporum orbiculare) | 0.5514 | <0.10 |
Enterotoxin A (S.aureus) | 0.8355 | <0.10 |
Enterotoxin B (S.aureus) | 0.9488 | <0.10 |
Cockroach | 0.8575 | <0.10 |
IgG4 | IgE | PP Index | |||
PEG-Treated | Untreated | PEG-Treated | Untreated | ||
Serum mg/dL | Serum mg/dL | Serum mg/dL | Serum mg/dL | % | |
Present case | 1,460 | 3,110 | 237 | 376 | 63 |
Control 1 | 5.5 | 20.9 | 160 | 1880 | 8.5 |
Control 2 | 7.2 | 52.6 | 122 | 1960 | 6.2 |
Citation: Ota Y, Fujiwara M, Yoji H, Ota R, Suzuki M (2018) A Case of IgG4-Related Mikulicz’s Disease with Chronic Rhinosinusitis and Elevated Levels of IgG4-and IgE-Immune Complexes. J Otolaryng Head Neck Surg 4: 019.
Copyright: © 2018 Yasushi Ota, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.