Recurrent IgG4-Related Meningeal Disease of the Cervicothoracic Spine: A Case Report and Review of the Literature.
Neurol India
; 70(3): 1180-1186, 2022.
Article
em En
| MEDLINE
| ID: mdl-35864660
ABSTRACT
Background:
IgG4-related disease is a rare, recently recognized chronic inflammatory disease. IgG4-related hypertrophic pachymeningitis (IgG4-RHP) of the central nervous system predominantly involves the cranial meninges. Spinal involvement remains rare.Objective:
We report a case of recurrent cervicothoracic IgG4-RHP and review the surgical literature. Methods and Materials A 35-year-old woman presented with a 6-month history of neck and right shoulder pain, progressive right triceps weakness and paresthesias in the right C8 and T1 dermatomes. MRI demonstrated a T2 hypointense epidural soft tissue mass extending from C6-T1. The patient underwent C6-T1 laminoforaminotomy and partial resection with near complete symptom resolution. Histopathology was consistent with diagnosis of IgG4-RHP. Eighteen months postoperatively, she experienced symptom recurrence necessitating re-operation and adjuvant postoperative prednisone with complete resolution at 40-months' follow-up. Results andConclusions:
Of the now nineteen confirmed cases of IgG4-RHP, fifteen underwent surgery. A majority achieved partial resection. Three surgical patients did not receive adjuvant therapy with symptomatic recurrence between 2 and 18 months.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença Relacionada a Imunoglobulina G4
/
Meningite
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Neurol India
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos