Recurrent spinal IgG4-related hypertrophic pachymeningitis and its management: a case report

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The patient with recurrent IgG4-related hypertrophic pachymeningitis initially improved after decompression surgery and steroid therapy.
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Disease recurrence occurred after discontinuing steroid therapy due to intolerable side effects, prompting a new treatment regimen.
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Combined therapy with oral prednisolone and azathioprine led to significant clinical improvement and resolution of lesions on MRI.
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Steroid therapy is the first-line treatment for IgG4-RHP, with steroid-sparing agents recommended for refractory or recurrent cases.
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This case highlights the importance of monitoring serum IgG4 levels and imaging for assessing treatment response in IgG4-RHP.

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