IgG4-Related Hypertrophic Pachymeningitis: A Great Clinical Imitator

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Published: Jun 20, 2025
DOI: https://doi.org/10.47191/ijmscrs/v5-i06-21
Keywords:
IgG4-related disease, hypertrophic pachymeningitis, autoimmune meningeal disease, corticosteroids, methotrexate

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Manuel Alejandro Vega Villegas, M.D.
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Valentín Gómez Farias” Internal Medicine Department.Guadalajara, Jal, Mexico (https://orcid.org/0009-0006-8118-6119).
Daniel Vidrio Carrizales, M.D
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Valentín Gómez Farias” Internal Medicine Department.Guadalajara, Jal, Mexico (https://orcid.org/0009-0006-8368-8278).
Siomara Estefanía Luquin Ruiz, M.D.
Universidad Autónoma de Guadalajara” (https://orcid.org/0009-0001-6230-3248).
Mónica Susana García Bravo, M.D.
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Valentín Gómez Farias” Internal Medicine Department.Guadalajara, Jal, Mexico (https://orcid.org/0009-0003-9827-0366).

Abstract

We present a diagnostically challenging case of a 45-year-old woman with a long-standing clinical course characterized by episodic dysphonia, epistaxis, seizures, and cranial neuropathies. Extensive evaluations initially led to a suspected diagnosis of non-Hodgkin lymphoma. However, elevated serum IgG4 levels and histopathological reevaluation confirmed IgG4-related hypertrophic pachymeningitis. The patient responded well to methotrexate and prednisone. This case underscores the importance of considering IgG4-RD in unexplained meningeal syndromes and highlights the need for timely recognition to avoid invasive interventions.

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How to Cite
Vega Villegas, M.D., Manuel Alejandro, Daniel Vidrio Carrizales, Siomara Estefanía Luquin Ruiz, and Mónica Susana García Bravo. 2025. “IgG4-Related Hypertrophic Pachymeningitis: A Great Clinical Imitator”. International Journal of Medical Science and Clinical Research Studies 5 (6):941-42. https://doi.org/10.47191/ijmscrs/v5-i06-21.
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Vol. 5 No. 6 (2025): Volume 05 Issue 06 June 2025
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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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