Page 95 - Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022

Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022
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14 MOH-AMM Scientific Meeting 2022 in conjunction with 23 NIH Scientific Conference Abstract Book
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INTRODUCTION: Globally, cancer or neoplasm burden continues to grow, as the second
leading cause of death in 2018. By having a reliable summary measure of mortality, most
preventable death can be avoided by providing the best healthcare solution, management
and specific health surveillance. This study was conducted to describe the major causes of
premature mortality by neoplasms in Malaysia in 2019.
METHODS: Premature mortality, measured in terms of Years of Life Lost (YLL), is any death
that occurs before life expectancy is reached within a given population, based on the method
by the Global Burden of Disease (GBD) study. YLL was determined by the age-sex-specific
numbers of death and life expectancy at death. Mortality data were obtained from the
Department of Statistics Malaysia.
RESULTS: Neoplasms’ premature mortality contributed to 16.5% of total YLL in 2019. YLL by
neoplasms among females [51.2%] is higher than in males [48.8%]. By gender specific and age
group, leukaemia was the major cause of YLL among the zero to 14 years old females and
males, while breast cancer contributed the most among women aged 15 years old and above.
In males, colon and rectum cancers were the leading causes of YLL among 15 to 49 years old,
while trachea, bronchus and lung cancers were the leading neoplasms in males aged 50 years
and above.
DISCUSSION/CONCLUSION: Having a better estimate on burden of neoplasms may increase
the survival rates of various types of neoplasms, providing multiple efforts or programmes for
early detection, quality treatment and survivorship care.

ID 96 IGG4 RELATED DISEASE IN A YOUNG ADULT: A DIAGNOSTIC CHALLENGE

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Prasobhan Bala Krishnan , Yong Kar Ying , Teresa Chua Fuh Guang , Adiratna Mat Ripen
1 Allergy & Immunology Research Centre, Institute for Medical Research, Malaysia
2 Department of Hematology, Hospital Miri, Sarawak, Malaysia
3 Department of Pathology, Hospital Umum Sarawak, Malaysia

CASE DESCRIPTION: This is a case of a 28 years old gentleman who presented with right sided
neck swelling for the past eight years. He has profound weight loss of 26 kilograms over 1
year. There is no shortness of breath, bone pain or altered bowel habits. The swelling
measures 8cm x 15 cm, is firm and non-tender. The MRI of the neck revealed multiple well
encapsulated, matted, lobulated right cervical lymphadenopathy. The lymph node biopsy
showed many IgG4+ plasma cells, up to 70 cells per high power field but the IgG4+/IgG plasma
cell ratio is 20%. There is no stromal fibrosis, obliterative phlebitis, granuloma or malignant
cells. The serum IgG4 subclass was raised at 258 mg/dl. His bone marrow aspirate showed a
reactive plasmacytosis without marrow infiltration or acute leukaemia. The serum and urine
electrophoresis did not reveal any para-protein bands. Treatment with glucocorticoids was
commenced along with azathioprine. He responded well by gaining weight and showed
reduction in the size of neck swelling.
DISCUSSION/CONCLUSION: IgG4 related disease (IgG4-RD) is a systemic fibro-inflammatory
disease characterized by infiltration of IgG4-positive plasma cells in the tissue. It is often
unrecognized and the prevalence is obscure. The challenge in this case comes as the
IgG4+/IgG plasma cell ratio is only 20% whereas the number of IgG4+ plasma cells is > 10/high
power field. The serum IgG4 level is also > 135 mg/dl. Therefore, based on the revised
comprehensive diagnosis (RCD) 2020 for IgG4-RD, this fits as a probable IgG4 related disease.

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