A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome

We herein report a 75-year-old man who developed disturbed consciousness with polynuclear cell dominant pleocytosis and low glucose and extremely high interleukin (IL)-6 levels in his cerebrospinal fluid. The biopsy specimen from his right supraclavicular lymph node showed the infiltration of inflam...

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Autores principales: Matsumoto, Namiko, Hishikawa, Nozomi, Ikegami, Ken, Sato, Kota, Omote, Yoshio, Takemoto, Mami, Yamashita, Toru, Taniguchi, Kohei, Abe, Koji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313933/
https://www.ncbi.nlm.nih.gov/pubmed/33390491
http://dx.doi.org/10.2169/internalmedicine.6098-20
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author Matsumoto, Namiko
Hishikawa, Nozomi
Ikegami, Ken
Sato, Kota
Omote, Yoshio
Takemoto, Mami
Yamashita, Toru
Taniguchi, Kohei
Abe, Koji
author_facet Matsumoto, Namiko
Hishikawa, Nozomi
Ikegami, Ken
Sato, Kota
Omote, Yoshio
Takemoto, Mami
Yamashita, Toru
Taniguchi, Kohei
Abe, Koji
author_sort Matsumoto, Namiko
collection PubMed
description We herein report a 75-year-old man who developed disturbed consciousness with polynuclear cell dominant pleocytosis and low glucose and extremely high interleukin (IL)-6 levels in his cerebrospinal fluid. The biopsy specimen from his right supraclavicular lymph node showed the infiltration of inflammatory cells positive for IgG, IgG4 and IL-6. Prednisolone and azathioprine administered under suspicion of IgG4-related disease (IgG4-RD) or multicentric Castleman’s disease (MCD) successfully remitted the symptoms. However, he developed myelodysplastic syndrome (MDS) and died 18 months later. The extremely high IL-6 may have been related to the rare neurological manifestations and development of MDS in the present case.
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spelling pubmed-83139332021-08-11 A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome Matsumoto, Namiko Hishikawa, Nozomi Ikegami, Ken Sato, Kota Omote, Yoshio Takemoto, Mami Yamashita, Toru Taniguchi, Kohei Abe, Koji Intern Med Case Report We herein report a 75-year-old man who developed disturbed consciousness with polynuclear cell dominant pleocytosis and low glucose and extremely high interleukin (IL)-6 levels in his cerebrospinal fluid. The biopsy specimen from his right supraclavicular lymph node showed the infiltration of inflammatory cells positive for IgG, IgG4 and IL-6. Prednisolone and azathioprine administered under suspicion of IgG4-related disease (IgG4-RD) or multicentric Castleman’s disease (MCD) successfully remitted the symptoms. However, he developed myelodysplastic syndrome (MDS) and died 18 months later. The extremely high IL-6 may have been related to the rare neurological manifestations and development of MDS in the present case. The Japanese Society of Internal Medicine 2020-12-29 2021-07-01 /pmc/articles/PMC8313933/ /pubmed/33390491 http://dx.doi.org/10.2169/internalmedicine.6098-20 Text en Copyright © 2021 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Matsumoto, Namiko
Hishikawa, Nozomi
Ikegami, Ken
Sato, Kota
Omote, Yoshio
Takemoto, Mami
Yamashita, Toru
Taniguchi, Kohei
Abe, Koji
A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title_full A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title_fullStr A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title_full_unstemmed A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title_short A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome
title_sort unique case of encephalopathy with an elevated igg-4 and extremely high interleukin-6 level and delayed myelodysplastic syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313933/
https://www.ncbi.nlm.nih.gov/pubmed/33390491
http://dx.doi.org/10.2169/internalmedicine.6098-20
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