"Stomach mass" as the first manifestation of IgG4-related disease: a case report.

BACKGROUND: IgG4-related disease mainly manifests as organomegaly and is accompanied by tissue fibrosis (Mimori, Mod Rheumatol 29(2):213, 2019) which is frequently confused with tumour (Dawei et al., J Gastroenterol Hepatol 29(12):1375-8, 2020). There are few reports with of IgG4-related disease with the first clinical manifestation involving the stomach.

CASE PRESENTATION: We present the case of 46-year-old male patient with a "stomach tumour" as the first manifestation of IgG4-related disease. Gastroscopy showed a mass in the stomach, however, the pathology result was chronic inflammation with IgG4 positivity. CT scans of abdomen showed that the stomach wall was thick, the head of the pancreas was swollen, and retroperitoneal fibrosis was severe.The serum IgG4 level was 75 g/L (normal range 0.03-2.01 g/L).After treatment with methylprednisolone for one month, the symptoms were greatly relieved.

CONCLUSIONS: To reduce the suffering of patients and relieve their financial burden, we should consider the possibility of IgG4-related disease when the initial manifestation is a stomach mass.