Immunoglobulin G4-related disease requiring clinical attention: A case report and review of literature

BACKGROUND: Immunoglobulin G4 (IgG4)-related disease (IgG4-RD), a relatively rare immune-mediated chronic inflammatory condition characterized by fibrosis, is capable of affecting multiple organs and systems. Epidemiologically, the disease predominantly affects middle-aged and older men in Asian populations, whereas it shows a female predominance in the corresponding age group in the United States. In IgG4-RD, affected tissues and organs may exhibit diffuse or localized swelling, mimicking neoplastic lesions. IgG4-related cholecystitis (IgG4-CC) represents a manifestation involving the gallbladder, with isolated gallbladder involvement without other organ lesions being exceptionally uncommon. CASE SUMMARY: A 53-year-old man was admitted to the hospital with abdominal pain. Preoperative evaluations could not exclude gallbladder carcinoma, and surgical intervention was required. Based on intraoperative findings, postoperative pathology, and postoperative serum IgG4 levels, a diagnosis of IgG4-CC was considered. After glucocorticoid therapy, the patient's general condition substantially improved. CONCLUSION: For patients present with space-occupying lesions of the gallbladder, IgG4-RD should be included in the differential diagnosis.