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Case report
Generalised gingival enlargement as a sole manifestation of IgG4-related disease
  1. Ashima Goyal1,
  2. Mrinalini Rathore1,
  3. Sanjeev Kumar Singh1 and
  4. Ritambara Nada2
  1. 1Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Mrinalini Rathore; rathoremrinalini{at}


An 18-year-old woman presented with enlarged gingivae of 1-year duration with no history of drug consumption or systemic conditions that might explain the enlargement. Biopsy revealed hyperplastic gingival epithelium and a plasma cell-rich inflammatory infiltrate in the subepithelial connective tissue with the presence of scattered multinucleated giant cells. Immunostaining revealed the plasma cells to be positive for IgG4. Serum IgG4 levels were elevated at 3.6 g/L (reference range: 0.049–1.985). These findings led towards the diagnosis of an IgG4-related disease (RD). Other granulomatous conditions were also ruled out via series of investigations. The enlarged tissue was surgically excised. No corticosteroids were administered owing to the localised nature of the manifestations. After 3 months, the gingival size remained unchanged. This case has been reported with a relatively shorter follow-up period because of the rarity of the presentation. IgG4-RD should be considered while diagnosing a patient with gingival enlargement.

  • dentistry and oral medicine
  • immunology
  • mouth
  • pathology
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  • Contributors AG involved in patient care, concept and critical revision of manuscript. MR involved in review of literature, and preparation of manuscript. SKS involved in patient care and revision of manuscript. RN involved in the histopathological examination and contributed the respective images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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