18 F-FDG PET/CT in Pediatric Immunoglobulin G4-Related Disease.

Singh, Karan; Bennett, Olivia; Wegner, Eva Alina; Marsden, Amanda; Grewal, Davinder Singh · Clin Nucl Med · 2024

case_report · Level V

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Abstract

A 14-year-old boy presented with severe, nonintentional weight loss, fatigue, and cough. Investigations were notable for raised inflammatory markers and significantly elevated serum immunoglobulin G4 (IgG4). 18 F-FDG PET/CT was obtained for assessment of disease involvement and extent, to exclude differential diagnoses and to guide biopsy. The study demonstrated extensive FDG-avid nodal disease and multisystem organ involvement. Excisional biopsy of a right inguinal lymph node demonstrated reactive changes with numerous IgG4-positive plasma cells consistent with IgG4-related disease. He was commenced on immunosuppressive therapy with consequent weight restoration and symptom resolution.

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