Usami Toshihiko, Kawashima Shoji, Ueki Yoshino, Toyoda Takanari, Okita Kenji, Matsukawa Noriyuki
Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, 1 Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan.
eNeurologicalSci. 2018 Jan 4;10:45-47. doi: 10.1016/j.ensci.2017.12.005. eCollection 2018 Mar.
IgG4-related disease (IgG4-RD) is a recently recognized disease entity. A 74-year-old male presented with transient headache. He was diagnosed IgG4-RD by pancreatic biopsy at the age of 72. Magnetic Resonance Imaging (MRI) showed disseminated cerebral microbleeds and microinfarctions in time and space. It suggested cerebral vasculitis, however any causative factor were not confirmed. IgG4-RD rarely causes cerebral vasculitis. This might be a first case of an asymptomatic cerebral vasculitis due to IgG4-RD. Patient was started on oral prednisolone, and no neurological or neuropsychological symptom was clinically observed. The MRI findings improved after treatment, and revealed no indication of newly lesions at 6-months follow-up. Early treatment for IgG4-RD may be recommended to prevent irreversible cognitive dysfunction.
IgG4相关疾病（IgG4-RD）是一种最近才被认识的疾病实体。一名74岁男性出现短暂性头痛。他在72岁时经胰腺活检被诊断为IgG4-RD。磁共振成像（MRI）显示在时间和空间上散在的脑微出血和微梗死。提示为脑血管炎，但未证实任何致病因素。IgG4-RD很少引起脑血管炎。这可能是首例由IgG4-RD导致的无症状性脑血管炎。患者开始口服泼尼松龙，临床上未观察到神经或神经心理症状。治疗后MRI表现改善，在6个月随访时未发现新病灶迹象。可能建议对IgG4-RD进行早期治疗以预防不可逆的认知功能障碍。
