与IgG4疾病相关的硬脊膜炎：脊髓压迫的一种极为罕见的病因。
Epiduritis related to IgG4 disease: A very rare cause for spinal cord compression.
作者信息
Gader Ghassen, Atig Fatma Ben, Jemel Nesrine, Bourgou Malek, Slimane Abdelhafidh, Ghedira Khalil, Badri Mohamed, Zammel Ihsèn
机构信息
Department of Neurosurgery, Trauma and Burns Center, Ben Arous, Tunisia.
Department of Neurosurgery, National Institute of Neurology, Tunis, Tunisia.
出版信息
Surg Neurol Int. 2023 Jun 16;14:205. doi: 10.25259/SNI_400_2023. eCollection 2023.
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.
背景
炎性假瘤较为罕见，而由免疫球蛋白G4（IgG4）疾病引起的炎性假瘤则更为少见。在此，我们回顾了文献中41例由IgG4引起的脊柱炎性假瘤病例，并补充了我们的1例新病例。
病例报告
一名25岁男性出现进行性背痛、双侧下肢轻瘫和括约肌功能障碍。其神经功能缺损归因于磁共振成像（MR）记录的T5至T10水平的后外侧病变，为此他接受了T1-T10椎板切除术。病理检查显示为免疫球蛋白G4相关性炎性假瘤。术后，患者还需要全身及硬膜外给予糖皮质激素。
结论
IgG4相关性疾病是一种新兴的临床病症，很少累及中枢神经系统。在压迫脊髓病变的潜在鉴别诊断中，应更普遍地考虑包括IgG4疾病在内的脊柱炎性假瘤。
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