Normal pressure hydrocephalus, a possible complication in IgG4-related disease

Hiroshi Kobayashi; Masaaki Uehara; Aya Oda; Erika Matsubara; Hiroyuki Baba; Ryo Matsumiya; Noritada Yoshikawa; Osamu Hosono; Hirotoshi Tanaka

doi:10.1016/j.inat.2016.03.009

Interdisciplinary Neurosurgery (Sep 2016)

Normal pressure hydrocephalus, a possible complication in IgG4-related disease

Hiroshi Kobayashi,
Masaaki Uehara,
Aya Oda,
Erika Matsubara,
Hiroyuki Baba,
Ryo Matsumiya,
Noritada Yoshikawa,
Osamu Hosono,
Hirotoshi Tanaka

Affiliations

Hiroshi Kobayashi: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Masaaki Uehara: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Aya Oda: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Erika Matsubara: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Hiroyuki Baba: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Ryo Matsumiya: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Noritada Yoshikawa: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Osamu Hosono: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Hirotoshi Tanaka: Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan

DOI: https://doi.org/10.1016/j.inat.2016.03.009
Journal volume & issue: Vol. 5, no. C
pp. 1 – 2

Abstract

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We report a 75-year-old man with glucocorticoid-responsive normal pressure hydrocephalus (NPH) complicated with tubulointerstitial renal disease, protein-losing gastroenteropathy (PLG) and elevated serum IgG4, which might be a possible subset of IgG4-related disease (IgG4-RD). Although either PLG or NPH, especially in combination, has rarely been reported in IgG4-RD, the glucocorticoid-responsive nature of every abnormality observed in the patient supports the diagnosis of IgG4-RD. Of course, pathological confirmation is essential to fulfill the recently raised diagnostic criteria, however, such invasive procedure might not always be indicated in high-risk patients. Our report illustrates that IgG4-RD might be considered as one of the underlying causes and/or the aggravating factors of NPH before shunt operation.

Published in Interdisciplinary Neurosurgery

ISSN: 2214-7519 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: http://www.journals.elsevier.com/interdisciplinary-neurosurgery/

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