Case report: IgG4-related intracranial lesions mimicking multiple sclerosis in a 14-year-old girl.
Case report: IgG4-related intracranial lesions mimicking multiple sclerosis in a 14-year-old girl.
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DOI：
10.3389/fneur.2022.1007153
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发表时间：
2022
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
IgG 4相关疾病（IgG 4-RD）的特征是IgG 4阳性浆细胞在各种组织和器官中的浸润。即便如此，与IgG 4-RD相关的中枢神经系统病变很少。我们提出了一个病例IgG 4相关的脑实质病变，模仿多发性硬化症在一个年轻的女孩。我们的神经病学和风湿病学团队对患者进行了随访。记录临床信息，并使用磁共振成像（MRI）筛选大脑。在随访期间，我们检测了血清IgE、IgG和IgG 4以及淋巴结活检。我们报告一位十四岁的中国女孩，因复视、左眼睑下垂、右面部麻木、右下肢无力而住进本院。脑MRI显示脑实质和脊髓多发性硬化样病变。在随访期间，她出现了淋巴结病。血清、IgG、IgG 4和IgE升高以及淋巴结活检有利于IgG 4-RD的诊断。患者对糖皮质激素和吗替麦考酚酯反应良好。文献综述总结了8例既往报道的累及脑实质的IgG 4-RD。我们的病例扩展了已知的IgG 4-RD年龄谱。颅内IgG 4-RD是罕见的，可以模仿多发性硬化症。仔细检查和动态回顾病史是鉴别诊断的关键。
IgG4-related disease (IgG4-RD) is distinguished by the infiltration of IgG4-positive plasma cells in a variety of tissues and organs. Even so, central nervous system lesions associated with IgG4-RD are scarce. We present a case of IgG4-related brain parenchymal lesions that mimics multiple sclerosis in a young girl. The patient was followed by our neurology and rheumatology teams. Clinical information was recorded, and the brain was screened using magnetic resonance imaging (MRI). During follow-up, we examined serum IgE, IgG and IgG4 and lymph node biopsy. Here, we presented details of a 14-year-old Chinese girl suffering from diplopia, left eyelid ptosis, right facial numbness, and right lower limb weakness admitted to our institute. Brain MRI revealed multiple sclerosis-like lesions in the brain parenchyma and spinal cord. During the follow-up, she developed lymphadenopathy. Elevation of serum, IgG, IgG4 and IgE and lymph node biopsy favors a diagnosis of IgG4-RD. The patient had a good response to glucocorticoids and mycophenolate mofetil. The literature review summarized eight previously reported IgG4-RD involving brain parenchyma. Our case expands the known age spectrum of IgG4-RD. The intracranial IgG4-RD is rare and could mimic multiple sclerosis. Careful examination and dynamic review of disease history are crucial in the differential diagnosis.
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影响因子：
11.2
作者：
Polman CH;Reingold SC;Banwell B;Clanet M;Cohen JA;Filippi M;Fujihara K;Havrdova E;Hutchinson M;Kappos L;Lublin FD;Montalban X;O'Connor P;Sandberg-Wollheim M;Thompson AJ;Waubant E;Weinshenker B;Wolinsky JS
通讯作者：
Wolinsky JS
影响因子：
11.2
作者：
Barkhof, F;Rocca, M;Filippi, M
通讯作者：
Filippi, M
影响因子：
--
作者：
Khosroshahi, Arezou;Bloch, Donald B.;Stone, John H.
通讯作者：
Stone, John H.
影响因子：
5.6
作者：
Chasset F;Dayer JM;Chizzolini C
通讯作者：
Chizzolini C
影响因子：
27.4
作者：
Wallace, Zachary S.;Zhang, Yuqing;Zhang, Wen
通讯作者：
Zhang, Wen