ArticleCureus2025
Atypical Presentation of IgG4-Related Disease: A Case Report of Obstructive Seminal Vesiculitis.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory condition known to form "pseudotumors" that mimic malignancy. We previously reported the case of a 59-year-old male who presented with acute kidney injury from a unilateral ureteric obstruction, diagnosed as right-sided seminal vesiculitis. We now report the crucial clinical follow-up. During surveillance, the patient developed a new, contralateral pelvic mass and presacral thickening. A PET-CT scan confirmed high metabolic activity, raising suspicion for malignancy. Serological testing was definitive, revealing a markedly elevated serum IgG4 level of 7.76 g/L (normal <1.3 g/L). A CT-guided biopsy of the new lesion excluded malignancy and showed a dense lymphoplasmacytic infiltrate with an IgG4/IgG ratio >40%. The diagnosis was revised to multifocal IgG4-RD. The patient was commenced on Rituximab, which led to a marked improvement in both his serological markers and associated joint symptoms. This case demonstrates that a focal urological finding like seminal vesiculitis can be the novel debut presentation of a systemic IgG4-related disease, highlighting the need for a high index of suspicion for systemic inflammatory conditions in cases of atypical or evolving urological masses.
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