Bouayad A, El Oumri AA. Immunoglobulin G4 biomarkers and pathogenesis in immunoglobulin G4-related spinal pachymeningitis. World J Clin Cases 2025; 13(22): 105331 [DOI: 10.12998/wjcc.v13.i22.105331]
Corresponding Author of This Article
Abdellatif Bouayad, MD, Associate Professor, Laboratory of Immunology, Faculty of Medicine and Pharmacy Oujda, Mohammed First University, Oujda l’Université, 60049 Oujda, Oujda-Angad 4867, Oriental, Morocco. a.bouayad@ump.ac.ma
Research Domain of This Article
Immunology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Immunoglobulin G4 biomarkers and pathogenesis in immunoglobulin G4-related spinal pachymeningitis
Abdellatif Bouayad, Ahmed Amine El Oumri
Abdellatif Bouayad, Laboratory of Immunology, Faculty of Medicine and Pharmacy Oujda, Mohammed First University, Oujda-Angad 4867, Oriental, Morocco
Ahmed Amine El Oumri, Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda-Angad 4867, Oriental, Morocco
Co-first authors: Abdellatif Bouayad and Ahmed Amine El Oumri.
Author contributions: Bouayad A wrote and designed the article; Bouayad A and El Oumri AA reviewed the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdellatif Bouayad, MD, Associate Professor, Laboratory of Immunology, Faculty of Medicine and Pharmacy Oujda, Mohammed First University, Oujda l’Université, 60049 Oujda, Oujda-Angad 4867, Oriental, Morocco. a.bouayad@ump.ac.ma
Received: January 18, 2025 Revised: April 1, 2025 Accepted: April 9, 2025 Published online: August 6, 2025 Processing time: 116 Days and 6.7 Hours
Abstract
This letter to the editor highlights adding the diagnostic utility of immunoglobulin G4 (IgG4) measurements and its potential role in IgG4-related spinal pachymeningitis (IgG4-RSP) pathogenesis to the case reported by Chae TS et al, which focused on IgG4-RSP diagnosis based on magnetic resonance imaging findings and increased plasma IgG4 concentrations. A comprehensive understanding of both IgG4 serological and cerebrospinal fluid biomarkers is essential for managing this complex condition.
Core Tip: Immunoglobulin G4 (IgG4)-related spinal pachymeningitis is a rare inflammatory disorder affecting the spinal dura mater. Although increased serum IgG4 levels are commonly reported, they lack specificity when used in isolation. Cerebrospinal fluid-based biomarkers, such as the IgG4 indices and the presence of IgG4-specific oligoclonal bands, may provide a reliable alternative to meningeal biopsy, particularly when the latter is contraindicated or yields inconclusive results. These biomarkers offer advantages in terms of cost, accessibility, sensitivity, and specificity. Clarifying the pathogenic vs regulatory role of IgG4 is critical for both diagnosis and treatment.
