Immunoglobulin G4-related spinal pachymeningitis:A case report  

作　　者：Tae-Seok Chae Da-Sol Kim Gi-Wook Kim Yu Hui Won Myoung-Hwan Ko Sung-Hee Park Jeong-Hwan Seo 

机构地区：[1]Department of Physical Medicine&Rehabilitation,Jeonbuk National University Medical School,Jeonju 54907,South Korea [2]Department of Physical Medicine&Rehabilitation,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital,Jeonju 54907,South Korea

出　　处：《World Journal of Clinical Cases》2024年第32期6551-6558,共8页世界临床病例杂志（英文）

摘　　要：BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis,which manifests as inflammation of the dura mater in intracranial or spinal regions.Although IgG4-RD can affect multiple areas,the spine is a relatively rare site compared to the more frequent involvement of intracranial structures.CASE SUMMARY A 70-year-old male presented to our hospital with a two-day history of fever,altered mental status,and generalized weakness.The initial brain magnetic resonance imaging(MRI)revealed multiple small infarcts across various cerebral regions.On the second day after admission,a physical examination revealed motor weakness in both lower extremities and diminished sensation in the right lower extremity.Electromyographic evaluation revealed findings consistent with acute motor sensory neuropathy.Despite initial management with intravenous immunoglobulin for presumed Guillain-Barrésyndrome,the patient exhibited progressive worsening of motor deficits.On the 45th day of hospitalization,an enhanced MRI of the entire spine,focusing specifically on the thoracic 9 to lumbar 1 vertebral level,raised the suspicion of IgG4-related spinal pachymeningitis.Subsequently,the patient was administered oral prednisolone and participated in a comprehensive rehabilitation program that included gait training and lower extremity strengthening exercises.CONCLUSION IgG4-related spinal pachymeningitis,diagnosed on MRI,was treated with corticosteroids and a structured rehabilitation regimen,leading to significant improvement.

关 键 词：Immunoglobulin G4 related disease Immunoglobulin G4 related spinal pachymeningitis Manual motor test ELECTROMYOGRAPHY Magnetic resonance imaging Case report 

分 类 号：R593.2[医药卫生—内科学]