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Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review
IgG4-related disease is an immune-mediated systemic inflammatory condition characterized by tissue infiltration of IgG4-positive plasma cells and elevated serum IgG4 concentrations. Peripheral neuropathy is an atypical manifestation of this disease. We describe an unusual case of vasculitic neuropat...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dustri-Verlag Dr. Karl Feistle
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383847/ https://www.ncbi.nlm.nih.gov/pubmed/34085635 http://dx.doi.org/10.5414/CN110547 |
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author | Jiang, Benjamin Sahenk, Zarife Satoskar, Anjali Freimer, Miriam Ayoub, Isabelle |
author_facet | Jiang, Benjamin Sahenk, Zarife Satoskar, Anjali Freimer, Miriam Ayoub, Isabelle |
author_sort | Jiang, Benjamin |
collection | PubMed |
description | IgG4-related disease is an immune-mediated systemic inflammatory condition characterized by tissue infiltration of IgG4-positive plasma cells and elevated serum IgG4 concentrations. Peripheral neuropathy is an atypical manifestation of this disease. We describe an unusual case of vasculitic neuropathy in a patient with IgG4-related kidney disease. A 55-year-old woman presented with right leg weakness progressing to bilateral leg weakness, pain and numbness of the legs, and impaired gait. She was previously evaluated for weight loss and anemia with a CT scan of the abdomen due to concern for malignancy. Abnormal enhancement of the kidneys was seen, and laboratory work-up and kidney biopsy were consistent with IgG4-related disease. Myeloperoxidase-antineutrophil cytoplasmic antibodies were also positive. In combination with the patient’s asymmetric leg weakness and painful neuropathy, this raised concern for vasculitis. Sural nerve biopsy confirmed vasculitic neuropathy. Recent studies have demonstrated an overlap in the clinical characteristics of IgG4-related disease and the anti-neutrophil cytoplasmic antibody-associated vasculitides, which are known to cause vasculitic neuropathy. Clinicians should recognize this association, and IgG4-related disease should be considered in the differential diagnosis in patients with peripheral neuropathy in the right clinical context. |
format | Online Article Text |
id | pubmed-8383847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dustri-Verlag Dr. Karl Feistle |
record_format | MEDLINE/PubMed |
spelling | pubmed-83838472021-09-10 Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review Jiang, Benjamin Sahenk, Zarife Satoskar, Anjali Freimer, Miriam Ayoub, Isabelle Clin Nephrol Case Report IgG4-related disease is an immune-mediated systemic inflammatory condition characterized by tissue infiltration of IgG4-positive plasma cells and elevated serum IgG4 concentrations. Peripheral neuropathy is an atypical manifestation of this disease. We describe an unusual case of vasculitic neuropathy in a patient with IgG4-related kidney disease. A 55-year-old woman presented with right leg weakness progressing to bilateral leg weakness, pain and numbness of the legs, and impaired gait. She was previously evaluated for weight loss and anemia with a CT scan of the abdomen due to concern for malignancy. Abnormal enhancement of the kidneys was seen, and laboratory work-up and kidney biopsy were consistent with IgG4-related disease. Myeloperoxidase-antineutrophil cytoplasmic antibodies were also positive. In combination with the patient’s asymmetric leg weakness and painful neuropathy, this raised concern for vasculitis. Sural nerve biopsy confirmed vasculitic neuropathy. Recent studies have demonstrated an overlap in the clinical characteristics of IgG4-related disease and the anti-neutrophil cytoplasmic antibody-associated vasculitides, which are known to cause vasculitic neuropathy. Clinicians should recognize this association, and IgG4-related disease should be considered in the differential diagnosis in patients with peripheral neuropathy in the right clinical context. Dustri-Verlag Dr. Karl Feistle 2021-09 2021-06-04 /pmc/articles/PMC8383847/ /pubmed/34085635 http://dx.doi.org/10.5414/CN110547 Text en © Dustri-Verlag Dr. K. Feistle https://creativecommons.org/licenses/by/2.5/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Jiang, Benjamin Sahenk, Zarife Satoskar, Anjali Freimer, Miriam Ayoub, Isabelle Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title | Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title_full | Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title_fullStr | Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title_full_unstemmed | Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title_short | Vasculitic neuropathy associated with IgG4-related kidney disease: A case report and literature review |
title_sort | vasculitic neuropathy associated with igg4-related kidney disease: a case report and literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383847/ https://www.ncbi.nlm.nih.gov/pubmed/34085635 http://dx.doi.org/10.5414/CN110547 |
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