ArticleFrontiers in neurology
Case Report: IgG4-related disease presenting with prominent oculomotor nerve palsy.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder that uncommonly involves cranial nerves. Oculomotor nerve palsy as the predominant manifestation of IgG4-RD is exceptionally rare and may elude timely diagnosis due to nonspecific symptoms. Case presentation: A 76-year-old man presented with a two-month history of bilateral plantar numbness and pain, followed by nausea, vomiting, and headache. The patient was hospitalized twice: first in August 2025 in the Department of Hematology, and subsequently in October 2025 in the Department of Rheumatology and Immunology. Laboratory evaluation revealed markedly elevated immunoglobulins, prompting a comprehensive workup including bone marrow aspiration, positron emission tomography-computed tomography (PET-CT), and lymph node biopsy. Histopathology demonstrated reactive lymphoid hyperplasia with abundant IgG4 + plasma cell infiltration (IgG4+ > 100 cells/HPF; IgG4/IgG ratio >40%), which established the diagnosis of IgG4-RD according to the 2019 ACR/EULAR classification criteria. During the second hospitalization, the patient developed right ptosis and diplopia, and neurological examination confirmed isolated right oculomotor nerve palsy. Contrast-enhanced brain MRI showed no structural abnormalities, and CTA, along with CSF analysis, excluded alternative etiologies such as aneurysm, neoplasm, or infection. Treatment with intravenous methylprednisolone (40 mg daily) followed by oral mycophenolate mofetil (500 mg twice daily) led to significant clinical improvement of oculomotor palsy within 4 months, with normalization of serum IgG4 levels (from a peak of 74.3 g/L to 8.94 g/L at follow-up) and reduction of inflammatory markers. Conclusion: IgG4-RD should be considered in the differential diagnosis of unexplained cranial neuropathies, even in the absence of radiographic abnormalities. This case highlights that neurological recovery may be gradual and require sustained immunosuppression, and underscores the importance of multidisciplinary collaboration in managing atypical manifestations of IgG4-RD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.