PDF(Pubmed)
Abstract：
UNASSIGNED: Nervous system involvement in immunoglobulin G4-related disease (IgG4-RD) has been rarely reported.
UNASSIGNED: We describe an unusual case of IgG4-RD manifested as paresthesia in the right lower extremity. A 51-year-old male presented with paresthesia in the right S1-S3 regions. A neurological examination revealed peripheral neuropathy. Blood examination results were normal, barring slightly elevated IgG levels. Initial magnetic resonance imaging of the swollen right S1 and S2 nerve roots revealed lymphoma, schwannoma, and sarcoidosis. However, following the biopsy, the pathological findings were not typical of these diseases. Abdominal computed tomography revealed perirenal lesions, and IgG4-RD was suspected. The patient had a serum IgG4 level of 724 mg/dL. Additional pathological evaluations of the swollen S1 nerve revealed findings that corresponded to the diagnostic criteria for IgG4-RD. Oral steroid therapy was initiated, which improved paresthesia, and the swollen S1 nerve root gradually shrank.
UNASSIGNED: This report highlights a rare case of IgG4-RD involving nerve roots that neurosurgeons should consider.
UNASSIGNED: We describe an unusual case of IgG4-RD manifested as paresthesia in the right lower extremity. A 51-year-old male presented with paresthesia in the right S1-S3 regions. A neurological examination revealed peripheral neuropathy. Blood examination results were normal, barring slightly elevated IgG levels. Initial magnetic resonance imaging of the swollen right S1 and S2 nerve roots revealed lymphoma, schwannoma, and sarcoidosis. However, following the biopsy, the pathological findings were not typical of these diseases. Abdominal computed tomography revealed perirenal lesions, and IgG4-RD was suspected. The patient had a serum IgG4 level of 724 mg/dL. Additional pathological evaluations of the swollen S1 nerve revealed findings that corresponded to the diagnostic criteria for IgG4-RD. Oral steroid therapy was initiated, which improved paresthesia, and the swollen S1 nerve root gradually shrank.
UNASSIGNED: This report highlights a rare case of IgG4-RD involving nerve roots that neurosurgeons should consider.
摘要：
■很少报道神经系统参与免疫球蛋白G4相关疾病（IgG4-RD）。
■我们描述了一个不寻常的IgG4-RD病例，表现为右下肢感觉异常。一名51岁的男性在右侧S1-S3区域表现出感觉异常。神经系统检查显示周围神经病变。血液检查结果正常，除非IgG水平略有升高。右S1和S2神经根肿胀的初始磁共振成像显示淋巴瘤，神经鞘瘤,和结节病.然而,活检后,这些疾病的病理结果并不典型。腹部计算机断层扫描显示肾周病变，怀疑IgG4-RD。患者的血清IgG4水平为724mg/dL。对肿胀的S1神经的其他病理评估揭示了符合IgG4-RD诊断标准的发现。开始口服类固醇治疗，改善感觉异常，肿胀的S1神经根逐渐缩小。
本报告重点介绍了一例罕见的涉及神经根的IgG4-RD病例，神经外科医生应考虑。
■我们描述了一个不寻常的IgG4-RD病例，表现为右下肢感觉异常。一名51岁的男性在右侧S1-S3区域表现出感觉异常。神经系统检查显示周围神经病变。血液检查结果正常，除非IgG水平略有升高。右S1和S2神经根肿胀的初始磁共振成像显示淋巴瘤，神经鞘瘤,和结节病.然而,活检后,这些疾病的病理结果并不典型。腹部计算机断层扫描显示肾周病变，怀疑IgG4-RD。患者的血清IgG4水平为724mg/dL。对肿胀的S1神经的其他病理评估揭示了符合IgG4-RD诊断标准的发现。开始口服类固醇治疗，改善感觉异常，肿胀的S1神经根逐渐缩小。
本报告重点介绍了一例罕见的涉及神经根的IgG4-RD病例，神经外科医生应考虑。
