Persistent symptoms in a case of IgG4-related spinal inflammation
A man with inflammation and thickening of the spinal cord's covering had no symptom improvement after surgery, partial improvement with methylprednisolone, and no further relief with efgartigimod alfa.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
In this patient, surgery did not improve symptoms, methylprednisolone provided partial relief, and subsequent efgartigimod alfa provided no additional relief. Imaging also showed enlarging cavities within the spinal cord, and substantial neurological problems remained. This account documents a difficult clinical course, but it cannot establish which treatment works best or whether surgery caused the cavities.
The abstract does not give treatment durations, detailed symptom changes, or the length of follow-up. An individual patient's response cannot establish treatment effectiveness, and the literature summary does not resolve those gaps.
What the condition involved
Spinal pachymeningitis means inflammation of the spinal cord's outer covering. Here, tissue examination confirmed the IgG4-related diagnosis. The patient had leg weakness, numbness, back pain, and difficulty with urination and bowel movements; imaging showed spinal cord compression.
What the scans added
Later scans showed that cavities inside the spinal cord had enlarged compared with earlier images. That imaging change and the persistent neurological problems are separate observations from the partial symptom improvement reported during methylprednisolone treatment.
The original publication
A case of IgG4-related spinal pachymeningitis with a large spinal cord cavity: case report and updated systematic review.
Zhu J, Yu Y, Sun P et al.
Neurol Sci · 2025
- PubMed ID
- 40715640
- Record checked
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