IgG4-Related Disease Presenting as Hypertrophic Pachymeningitis.

IgG4-related disease (IgG4-RD) is a multi-organ, immune-mediated inflammatory condition of unknown etiology characterized by infiltration of tissues by IgG4 producing plasma cells. IgG4-related disease (IgG4-RD) can ideally affect any organs, but the involvement of the central nervous system (CNS) is a rare entity. We present a case of a 67-year-old male who presented with diplopia with imaging showing hypertrophic pachymeningitis (HPM) and was diagnosed with IgG4-RD of the CNS based on histopathology report.

Successful use of arterio-venous graft for hemodialysis in patient with hemophilia.

Hemodialysis (HD) is not the preferred approach for dialysis in patients with hemophilia. HD in such patients can possess a high risk of bleeding from arterio-venous cannulation and hence peritoneal dialysis is the first choice in patients with hemophilia. The bleeding risk can be overcome by the prophylactic administration of factor VIII, which is a very costly solution.

Guillain-Barré syndrome occurring synchronously with systemic lupus erythematosus as initial manifestation treated successfully with low-dose cyclophosphamide.

Systemic lupus erythematous (SLE) is frequently encountered in clinical practice; a widespread immunological response can involve any organ system, sometimes leading to rare and diagnostically challenging presentations. We describe a 38-year-old female who presented with symmetric numbness and tingling of the hands and feet, and cervical pain. Imaging studies were not diagnostic of any serious underlying pathology.