Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Immunoglobulin G4 (IgG4) related hypertrophic pachymeningitis of the spinal cord is a rare condition, characterized by infiltration of the spinal meninges with IgG4-producing plasma cells and subsequent hypertrophic fibrosis. Here, we report on a 65-year-old woman with IgG4 associated hypertrophic spinal pachymeningitis, in whom cerebrospinal fluid (CSF) analysis was a decisive diagnostic tool. Not only could we demonstrate an intrathecal IgG4 production, but also IgG4 positive plasma cells in CSF. Following decompressive surgery, diagnosis of IgG4 associated hypertrophic pachymeningitis was confirmed histologically. Surgery and immunosuppressive therapy with rituximab were associated with clinical improvement. This case highlights CSF analyses as diagnostic tool for detection of IgG4 related hypertrophic pachymeningitis.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11360877PMC
http://dx.doi.org/10.1186/s42466-024-00343-2DOI Listing

Publication Analysis

Top Keywords

hypertrophic pachymeningitis
16
intrathecal igg4
8
igg4 hypertrophic
8
plasma cells
8
igg4 associated
8
associated hypertrophic
8
diagnostic tool
8
igg4
7
hypertrophic
6
pachymeningitis
5

Similar Publications

Background: Surgical pathology specimens from patients with hypertrophic pachymeningitis are infrequently encountered. After excluding infectious and neoplastic causes, autoimmune conditions should be considered, especially neurosarcoidosis, rheumatoid arthritis, granulomatosis with polyangiitis (GPA), and IgG4-related disease (IgG4-RD) before the case is designated "idiopathic". However, even if histological findings strongly favor one of these conditions, clinical and serological correlation is mandatory.

View Article and Find Full Text PDF

Rheumatoid meningitis (RM), a rare neurological complication of rheumatoid arthritis (RA), presented as hypertrophic pachymeningitis and leptomeningitis in two octogenarian patients. Case 1 had established RA, while Case 2 was diagnosed with RA after neurological onset. Both patients initially received high doses of corticosteroids.

View Article and Find Full Text PDF

Microscopic polyangiitis (MPA) is a subtype of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a small-vessel vasculitis that can cause organ-threatening complications. Hypertrophic pachymeningitis is a rare, central nervous system manifestation of AAV rarely involving the spine. We herein report a patient with myeloperoxidase-ANCA-positive MPA presenting with progressive cognitive decline and gait disturbance associated with communicating hydrocephalus secondary to spinal hypertrophic pachymeningitis.

View Article and Find Full Text PDF

Primary central nervous system (CNS) mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition frequently mistaken for meningioma. Since these conditions require distinct treatment approaches, recognizing their imaging characteristics is essential for accurate clinical decision-making. A 69-year-old woman presented with headaches and forehead swelling, prompting MRI of the CNS.

View Article and Find Full Text PDF