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FeaturedCase ReportGastroenterology

Triple immune impairment in an elderly patient with IgG4-AIP and MGUS complicated by dual severe infections over 3 years: A case report.

Medicine (Baltimore)Nov 6, 2026

An 82-year-old man with IgG4-related autoimmune pancreatitis and IgGλ monoclonal gammopathy of undetermined significance had markedly elevated serum IgG4 and a monoclonal paraprotein at baseline.

Clinical pearl

In an older patient with IgG4-AIP and MGUS who develops severe infections during immunosuppression, consider combined disease-related and treatment-related immune impairment, including persistent cellular…

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