Symmetrical polyarthritis in IgG4-related sialadenitis: a diagnostic challenge with seronegative rheumatoid arthritis

IgG4-related disease (IgG4-RD) must be considered in the differential diagnosis of seronegative arthritis, especially when systemic symptoms or organ involvement are present. This case underscores the growing recognition of IgG4-RD in rheumatologic practice and the importance of a multidisciplinary approach to diagnosis and management. Clinicians should maintain heightened awareness of the overlap between IgG4-RD and rheumatoid arthritis (RA), advocating for the integration of histopathology, imaging, and serological testing to ensure accurate diagnosis. Additionally, long-term follow-up is essential to monitor disease progression, recurrence, development of new symptoms, and treatment response, ultimately enhancing patient care and outcomes.