[Clinicopathological features of neuropathy associated with IgG4-related disease]

Rinsho Shinkeigaku. 2014;54(12):1047-9. doi: 10.5692/clinicalneurol.54.1047.
[Article in Japanese]

Abstract

The newly recognized entity IgG4-related disease (IgG4-RD) is characterized by an elevated IgG4 serum concentration, swelling of organ, and tissue infiltration by IgG4-positive plasma cells with fibrosis. IgG4-RD has been reported in various organs. In the field of neurology, hypophysitis and hypertrophic pachymeningitis have been known to be related to IgG4-RD, while reported patients with neuropathy manifesting features compatible to IgG4-RD. The features of IgG4-related neuropathy are characterized by sensory-motor neuropathy, mononeuritis multiplex pattern, and predominant involvement of distal portions of the lower extremities. In the sural nerve biopsy specimens, fibrosis and IgG4-positive plasma cell infiltration in the epineurium and decreased myelinated fiber density due to axonal degeneration were observed. IgG4-RD should be considered as the differential diagnosis of neuropathy.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Axons / pathology
  • Fibrosis
  • Humans
  • Hypertrophy
  • Immunoglobulin G / blood*
  • Meningitis* / immunology
  • Meningitis* / pathology
  • Mononeuropathies
  • Nerve Degeneration / pathology
  • Nerve Fibers, Myelinated / pathology
  • Peripheral Nerves / pathology
  • Pituitary Diseases* / immunology
  • Pituitary Diseases* / pathology
  • Plasma Cells / immunology
  • Plasma Cells / pathology
  • Sural Nerve / pathology

Substances

  • Immunoglobulin G