Alteration of IgG4 levels in cerebrospinal fluid in IgG4‐related disease

Fernández‐Codina, Andreu; Hernández‐González, Manuel; Soláns-Laqué, Roser; Buján-Rivas, Segundo; Vilardell‐Tarrés, Miquel; Martínez‐Valle, Fernando

doi:10.1111/1756-185x.12739

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…The intrathecal synthesis of IgG4 in the CSF may also be used as a reference ( 8 , 13 , 16 , 26 , 33 , 39 ). Della-Torre et al ( 13 , 16 ) reported that in the CSF IgG4 index, the IgG4 CSF/IgG4 serum-to-albumin CSF/albumin serum ratio is a reliable marker for intrathecal IgG4 synthesis (normal range: 0.25-0.91).…”

Section: Discussionmentioning

confidence: 99%

Case report: Clinical highlights and radiological classification of IgG4-related spinal pachymeningitis: A rare case series and updated review of the literature

et al. 2023

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PurposeHypertrophic pachymeningitis associated with immunoglobulin G4-related disease (IgG4-RD) has been rarely reported, and there is little information and no clear consensus on the management of IgG4-related spinal pachymeningitis (IgG4-RSP). The present study described its possible clinical features, including the symptoms, imaging, treatment and prognosis of patients with IgG4-RSP.MethodsWe report three patients who presented with progressive neurological dysfunction due to spinal cord compression. Relevant articles were searched from the PubMed, Web of Science, and Embase databases, and the resulting literature was reviewed.ResultsThe literature review provided a summary of 45 available cases, which included three cases from our center. Progressive worsening of neurological impairment was observed in 22 patients (48.9%). The lesions involved the thoracic spine (n=28, 62.2%), cervical spine (n=26, 57.8%), lumbar spine (n=9, 20.0%), and sacral spine (n=1, 2.2%). Furthermore, the lesions were located in the dura mater (n=18, 40.0%), epidural space (n=17, 37.8%), intradural-extramedullary space (n=9, 20.0%), and intramedullary space (n=1, 2.2%). On magnetic resonance imaging (MRI), the lesions generally appeared as striated, fusiform, or less often lobulated oval changes, with homogeneous (n=17,44.7%) and dorsal (n=15,39.5%) patterns being the most common. Thirty-five patients had homogeneous T1 gadolinium enhancement. Early surgical decompression, corticosteroid treatment, and steroid-sparing agents offered significant therapeutic advantages. A good therapeutic response to disease recurrence was observed with the medication.ConclusionThe number of reported cases of IgG4-RSP remains limited, and patients often have progressive worsening of their neurological symptoms. The features of masses identified on the MRI should be considered. The prognosis was better with decompression surgery combined with immunosuppressive therapy. Long-term corticosteroid treatment and steroid-sparing agent maintenance therapy should be ensured. A systemic examination is recommended to identify the presence of other pathologies.

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Section: Discussionmentioning

confidence: 99%

Case report: Clinical highlights and radiological classification of IgG4-related spinal pachymeningitis: A rare case series and updated review of the literature

et al. 2023

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“…e authors certify that they have obtained all appropriate patient consent. [1,[3][4][5][6][7][8][9][11][12][13]15,[19][20][21][22][23][24][25][26][27][28][30][31][32][33][34]37,[40][41][42][43][44][45][46][47][48][49]…”

Section: Declaration Of Patient Consentmentioning

confidence: 99%

Epiduritis related to IgG4 disease: A very rare cause for spinal cord compression

Gader,

Atig,

Jemel

et al. 2023

Surgical Neurology International

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Background: Inflammatory pseudotumors are rare, and those attributed to immunoglobulin G4 (IgG4) diseases are even less frequently encountered. Here, we reviewed 41 cases from the literature of spinal inflammatory pseudotumors due to IgG4 and have added our single new case. Case Presentation: A 25-year-old male presented with progressive back pain, bilateral paraparesis, and sphincter dysfunction. His deficit was attributed to MR-documented posterolateral lesion between the T5 and T10 levels for which he levels underwent a T1–T1010 laminectomy. The pathology revealed an immunoglobulin G4-related inflammatory pseudotumor. Postoperatively, the patient additionally required systemic and epidural administration of glucocorticoids. Conclusion: IgG4-related disease is an emerging clinical condition that rarely involves the central nervous system. Spinal inflammatory pseudotumors, including IgG4 disease, should be more commonly considered among the potential differential diagnoses of lesions compressing the spinal cord.

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“…2. Магнитно-резонансная томография пациента с комбинированной базальной и конвекситальной церебральной формой IgG4-ассоциированного пахименингита (адаптировано из [59] с разрешения авторов). Представлены сагиттальные срезы после введения контрастного вещества (гадолиния) в режиме Т1.…”

Section: обзор литературыunclassified

“…2. Magnetic resonance imaging of a patient with combined basal and convexital cerebral form of IgG4-related pachymeningitis (reproduced from [59] with permission of the authors). Sagittal T1-weighted scans after contrast agent infusion.…”

Section: обзор литературыmentioning

confidence: 99%

Central nervous system damage in IgG4-related disease: review

Smirnov¹,

Грин²

2020

Nejrohirurgiâ (Mosk.)

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IgG4-related disease is a new and recently described and determined disease involving multiple organs. Its etiology and pathogenesis are still not fully understood. However according to multiple studies this disease should be considered as a unique pathological autoimmune unity involving various organs and tissues. IgG4-reladted disease was first considered as a form of pancreatic inflammatory process and diagnosed as IgG4-related autoimmune pancreatitis. However current data demonstrate the potential involvement of almost all tissues and organs including central nervous system. Diagnostic criteria are being reviewed annually resulting in IgG4-related disease diagnosis in many considered differently cases. This review presents current literature data related to IgG4-related disease etiology and pathogenesis, diagnostic criteria and potential forms of central nervous system IgG4-related injury.

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Alteration of IgG4 levels in cerebrospinal fluid in IgG4‐related disease

Cited by 7 publications

References 7 publications

Case report: Clinical highlights and radiological classification of IgG4-related spinal pachymeningitis: A rare case series and updated review of the literature

Case report: Clinical highlights and radiological classification of IgG4-related spinal pachymeningitis: A rare case series and updated review of the literature

Epiduritis related to IgG4 disease: A very rare cause for spinal cord compression

Central nervous system damage in IgG4-related disease: review

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