A rare case of IgG4-related disease causing inflammatory breast mass successfully treated with anti-CD20 biological therapy: a discussion of clinical case with literature review
  • Sufian Rifaei
    Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
  • Shahd Etoom
    Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
  • Mahmoud Al-Balas
    Faculty of Medicine, Hashemite University, Zarqa, Jordan

Keywords

IgG4-related disease, inflammatory lump, biological therapy, rituximab, anti-CD20 therapy

Abstract

We report a rare yet successful utilisation of anti-CD20 therapy using rituximab for treatment of a case of IgG4-related mastitis proven by clinical, serological, and histopathological evidence. This was affecting a mid-aged female who was referred to the rheumatology clinic by the breast surgeons to help assessing for the possibility of an underlying inflammatory process involving the breast tissue unilaterally.
The clinical course was apparently complex with an onset of an induration in the right lateral superior quadrant of the breast with mild discomfort and heaviness sensation. This increased over a course of 2 weeks before presentation to the general surgery clinic.
Subsequent investigations confirmed that the case was IgG4-related mastitis and a trial of steroids and disease modifying anti-rheumatic drugs (DMARDs) was partially helpful, but not to a full degree, mandating the utilisation of a more advanced mode of therapy, so rituximab was selected.

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References

  • Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012;366:539–551.
  • Kamisawa T, Zen Y, Pillai S, Stone JH. IgG4-related disease. Lancet 2015;385:1460–1471.
  • Khosroshahi A, Wallace ZS, Crowe JL, Akamizu A, Azumi A, Carruthers MN, et al. International Consensus Guidance Statement on the management and Treatment of IgG4-Related Disease. Arthritis Rheumatol 2015;67:1688–1699.
  • Yamada R, Horiguchi S, Yamashita T. IgG4-related mastitis, a rare disease, can radiologically and histologically mimic malignancy. BMJ Case Rep 2016;2016:bcr2016214870.
  • Umehara H, Okazaki K, Kawa S, Takahashi H, Goto H, Matsui S, et al. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD Mod Rheumatol 2021;31:529–533.
  • Kamisawa T, Okazaki K. Diagnosis and treatment of IgG4-related disease. Curr Top Microbiol Immunol 2017;401:19–33.
  • Tanaka Y, Stone JH. Perspectives on current and emerging therapies for immunoglobulin G4-related disease. Mod Rheumatol 2023;33:229–236.
  • Moutsopoulos HM, Fragoulis GE, Stone JH. Treatment and prognosis of IgG4-related disease. UpToDate 2022; https://medilib.ir/uptodate/show/121219
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    Published: 2024-03-29
    Issue: 2024: LATEST ONLINE (view)


    How to cite:
    1.
    Rifaei S, Etoom S, Al-Balas M. A rare case of IgG4-related disease causing inflammatory breast mass successfully treated with anti-CD20 biological therapy: a discussion of clinical case with literature review. EJCRIM 2024;11 doi:10.12890/2024_004450.