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Cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis: a case report and literature review

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Abstract

Purpose

To report a case of cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis (IgG4-RSP).

Methods

A 43-year-old male patient presented with ‘neck pain for 15 days, exacerbated accompanying motor and sensory dysfunction of lower limbs with bowel and bladder dysfunction for 4 days’ was admitted to our department. Combined with the history of ‘acupuncture treatment’, MRI results and rapid-developing progression, we considered the great possibilities of spinal cord compression by intradural hematoma and timely performed the emergency operation of cervical double-door laminoplasty and thoracic decompression with internal fixation.

Results

After combined therapy of dexamethasone, mannitol and neurotrophic drugs, sensory recovery of lower limbs started at the fifth day after operation and the sensory function became normal at the fourteenth day after operation with still complete loss of muscle strength. Pathological examination strongly suggested the diagnosis of IgG4-related sclerosing pachymeningitis (IgG4-RSP).

Conclusions

IgG4-related sclerosing pachymeningitis (IgG4-RSP) is a newly recognized disease. This case of cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis (IgG4-RSP) has never been reported in China with merely three case reports worldwide. Prompt surgical decompression is recommended and pathological examination is essential for diagnosis and comprehensive treatment.

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Authors and Affiliations

  1. Department of Orthopedics, China–Japan Union Hospital of Jilin University, 126 Xiantai Blvd, Changchun, 130033, People’s Republic of China

    Rui Gu, Peng-yuan Hao, Jia-bei Liu & Qing-san Zhu

  2. Department of Pathology, China–Japan Union Hospital of Jilin University, Changchun, 130033, People’s Republic of China

    Zhe-hui Wang

Authors
  1. Rui Gu
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  2. Peng-yuan Hao
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  3. Jia-bei Liu
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  4. Zhe-hui Wang
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  5. Qing-san Zhu
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Corresponding author

Correspondence to Jia-bei Liu.

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None of the authors has any potential conflict of interest.

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Gu, R., Hao, Py., Liu, Jb. et al. Cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis: a case report and literature review. Eur Spine J 25 (Suppl 1), 147–151 (2016). https://doi.org/10.1007/s00586-015-4251-0

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  • DOI: https://doi.org/10.1007/s00586-015-4251-0

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