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Immunoglobulin G4-related Disease Accompanied by Peripheral Neuropathy: A Report of Two Cases
Authors:Tomoya Kawazoe  Tomoyuki Inoue  Shinsuke Tobisawa  Keizo Sugaya  Toshio Shimizu  Kazuhito Miyamoto  Manaka Goto  Naoto Yokogawa  Sanami Azuma  Shingo Itagaki  Kenji Nishida  Yasuhiro Morita  Masahiro Nagao  Eiji Isozaki
Abstract:Due to its rarity and the limited literature, the clinicopathological characteristics of peripheral nerve involvement in immunoglobulin G4 (IgG4)-related disease are unknown. We present two cases of IgG4-related disease, accompanied by peripheral neuropathy, presenting as unilateral ptosis (case 1) and sclerosing cholangitis (case 2), respectively. In both cases, sural nerve biopsy indicated vasculitis as the underlying pathophysiology; the peripheral neuropathy was refractory to corticosteroid therapy. In contrast to the previously proposed pathomechanism of IgG4-related neuropathy (direct lymphoplasmacytic infiltration), the pathological findings in our cases suggest that vasculitis occurs secondary to systemic autoimmune conditions.
Keywords:case report  IgG4-related disease  systemic autoimmune disease  peripheral neuropathy  vasculitic neuropathy
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