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ISSN 1817-5996 (Electronic)

2019, Number S1

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Rev Cub de Reu 2019; 21 (S1)

IgG4-related hypertrophic pachymeningitis: communication of eleven other cases and literature review

Roverano S, Gallo J, Scolnik M, Reginato A, Segura V, Neira O

Language: Spanish
References: 12
Page: 1-7
PDF size: 321.98 Kb.


ABSTRACT

Pachymeningitis is a rare disorder characterized by focal or diffuse thickening of the dura mater, being a potential manifestation of the disease related to IgG4. We present 11 patients, six men and five women, aged 39-73 years, who consulted for headache, visual disturbances, tinnitus, hearing loss, weight loss, salivary gland enlargement, dorsalgia, quadriplegia and cranial nerve involvement. Some of them presented elevation of the C-reactive protein or the erythrocyte sedimentation value, while the majority had normal serum levels of IgG4. All patients showed thickening of the dura in magnetic resonance imaging. The biopsy of dura mater, gallbladder, pituitary gland or lacrimal gland showed a lymphoplasmacytic infiltrate with or without storiform fibrosis, with more than 10 IgG4 (+) plasmocytes and an IgG4: IgG range that ranged from 20 to 60%. Patients received prednisone alone or with rituximab, methotrexate, cyclophosphamide or azathioprine, with favorable response.


REFERENCES

  1. Kupersmith MJ; Martin V; Heller G; Shah A; Mitnick HJ. Idiopathic hypertrophic pachymeningitis. Neurology. 2004;62:686-94.

  2. Lindstrom KM; Cousar JB; Lopes MB. IgG4-related meningeal disease: clinico-pathological features and proposal for diagnostic criteria. Acta Neuropathol. 2010;120:765-76.

  3. Deshpande V; Zen Y; Chan JK, Yi EE; Sato Y; Yoshino T y col. Consensus statement on the pathology of IgG4-related disease. Mod. Pathol. 2012;25(9):1181-92.

  4. Wallace ZS; Carruthers MN; Khosroshahi; Carruthers R; Shinagare S; Stemmer-Rachamimov A y col. IgG4-related disease and hypertrophic pachymeningitis. Medicine (Baltimore). 2013;92(4):206-16.

  5. Riku S; Kato S. Idiopathic hypertrophic pachymeningitis. Neuropathology. 2003;23:335-44.

  6. Vanegas-García AL; Calle-López Y; Zapata CH; Alvarez-Espina DM; Saavedra-González YA; Arango-Viana JC. Afección del sistema nervioso central en le enfermedad relacionada con IgG4: descripción de un caso y revisión de la bibliografía. Rev. Neurol 2016; 63(3):119-24.

  7. Lu L; Della-Torre E; Stone J, Clark S. IgG4-related hypertrophic pachymeningitis: clinical features, diagnostic criteria and treatment. JAMA Neurol. 2014;71(6):785-93.

  8. Stone JH; Zen Y; Deshpande V. IgG4-related disease. N Engl J Med. 2012;366:539-51.

  9. Choi S-H; Lee S.H; Khang S.K; Jeon S.R. IgG4-related sclerosing pachymeningitis causing spinal cord compression. Neurology. 2010;75:1388-90.

  10. Rodríquez-Castro E; Fernández-Lebrero A; López-Dequidt IA; Rodríguez-Osorio X; López- González FJ; Suárez-Peñaranda JM y col. Paquimeningitis hipertrófica secundaria a enfermedad relacionada con IgG4: descripción de un caso y revisión de la bibliografía. Rev Neurol. 2015;61(7):308-12.

  11. Kamisawa T; Okazaki K; Kawa S; Shimosegawa T, Tanaka M. Research Committee for Intractable Pancreatic Disease and Japan Pancreas Society. Japanese consensus guidelines for management of autoimmune pancreatitis, III: treatment and prognosis of AIP. J Gastroenterol. 2010;45(5):471-7.

  12. Boban J, Ardali S, Thurnher M. Leptomeningeal form of Immunoglobulin G4-related hypertrophic meningitis with perivascular spread: a case report and review of the literature. Neuroradiology.[Internet] 2018.[citado 12 Ene 2019]. Disponible en: https://doi.org/10.1007/s00234-018-2028-y




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