Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report

An elevation in serum immunoglobulin (Ig) G4 concentrations at only one time point is not a definitive diagnostic marker for IgG4-related diseases. We report two cases of pulmonary paragonimiasis with elevated serum IgG4 concentrations. Patient 1 was a woman in her late 40s with cough and dyspnea fo...

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Main Authors: Pengyan Yin, Miaohui Duan, Lingyao Deng, Tianli Li, Xuan Huang, Raohong Fang, Hailong Li, Binliang Bai
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251317980
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author Pengyan Yin
Miaohui Duan
Lingyao Deng
Tianli Li
Xuan Huang
Raohong Fang
Hailong Li
Binliang Bai
author_facet Pengyan Yin
Miaohui Duan
Lingyao Deng
Tianli Li
Xuan Huang
Raohong Fang
Hailong Li
Binliang Bai
author_sort Pengyan Yin
collection DOAJ
description An elevation in serum immunoglobulin (Ig) G4 concentrations at only one time point is not a definitive diagnostic marker for IgG4-related diseases. We report two cases of pulmonary paragonimiasis with elevated serum IgG4 concentrations. Patient 1 was a woman in her late 40s with cough and dyspnea for 1 week. Patient 2 was a woman in her late 60s with a cough, bloody sputum, chest pain, and wheezing for over 1 month. Patient 1 had eosinophilia, high IgE, IgG, and IgG4 concentrations, right pleural effusion, and lung lesions, resembling tuberculosis. Patient 2 had cavitary lung lesions, pleural involvement, and eosinophilia, and high IgE, IgG, and IgG4 concentrations, with a history of eating raw river crabs. Both patients tested positive for Paragonimus antibodies. Patient 1 received 2 months of anti-parasitic treatment, while Patient 2 had 1 week of treatment. Patient 2 showed improvement and was discharged with normalized Ig concentrations. Increased serum IgG4 concentrations, in conjunction with elevated concentrations of IgG, IgE and eosinophil counts, and a history of travel or residence in areas endemic for paragonimiasis, can be used to distinguish pulmonary paragonimiasis from other etiologies of pneumonia.
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issn 1473-2300
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spelling doaj-art-4e52fd55f54c4520a712763b72176b982025-08-20T02:45:02ZengSAGE PublishingJournal of International Medical Research1473-23002025-02-015310.1177/03000605251317980Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case reportPengyan YinMiaohui DuanLingyao DengTianli LiXuan HuangRaohong FangHailong LiBinliang BaiAn elevation in serum immunoglobulin (Ig) G4 concentrations at only one time point is not a definitive diagnostic marker for IgG4-related diseases. We report two cases of pulmonary paragonimiasis with elevated serum IgG4 concentrations. Patient 1 was a woman in her late 40s with cough and dyspnea for 1 week. Patient 2 was a woman in her late 60s with a cough, bloody sputum, chest pain, and wheezing for over 1 month. Patient 1 had eosinophilia, high IgE, IgG, and IgG4 concentrations, right pleural effusion, and lung lesions, resembling tuberculosis. Patient 2 had cavitary lung lesions, pleural involvement, and eosinophilia, and high IgE, IgG, and IgG4 concentrations, with a history of eating raw river crabs. Both patients tested positive for Paragonimus antibodies. Patient 1 received 2 months of anti-parasitic treatment, while Patient 2 had 1 week of treatment. Patient 2 showed improvement and was discharged with normalized Ig concentrations. Increased serum IgG4 concentrations, in conjunction with elevated concentrations of IgG, IgE and eosinophil counts, and a history of travel or residence in areas endemic for paragonimiasis, can be used to distinguish pulmonary paragonimiasis from other etiologies of pneumonia.https://doi.org/10.1177/03000605251317980
spellingShingle Pengyan Yin
Miaohui Duan
Lingyao Deng
Tianli Li
Xuan Huang
Raohong Fang
Hailong Li
Binliang Bai
Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
Journal of International Medical Research
title Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
title_full Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
title_fullStr Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
title_full_unstemmed Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
title_short Initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin G4 concentrations: a case report
title_sort initial misdiagnosis to a revised diagnosis of pulmonary paragonimiasis with elevated serum immunoglobulin g4 concentrations a case report
url https://doi.org/10.1177/03000605251317980
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