Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2025; 13(22): 105331
Published online Aug 6, 2025. doi: 10.12998/wjcc.v13.i22.105331
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
Core Tip

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.