{"id":27275,"date":"2025-01-31T04:08:00","date_gmt":"2025-01-30T20:08:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27275"},"modified":"2025-01-31T05:54:37","modified_gmt":"2025-01-30T21:54:37","slug":"nejm%e4%b8%b4%e5%ba%8a%e5%8c%bb%e5%ad%a6%e5%bd%b1%e5%83%8f%ef%bc%9a%e5%a4%9c%e9%97%b4%e5%9f%83%e8%8f%b2%e5%b0%94%e9%93%81%e5%a1%94%e5%be%81","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27275","title":{"rendered":"[NEJM\u4e34\u5e8a\u533b\u5b66\u5f71\u50cf]\uff1a\u591c\u95f4\u57c3\u83f2\u5c14\u94c1\u5854\u5f81"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/browse\/nejm-media-type\/images-in-clinical-medicine\">IMAGES IN CLINICAL MEDICINE<\/a><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Eiffel-by-Night Sign<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Kundian\u00a0Guo,\u00a0Zhen\u00a0Hong<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med\u00a02024;391:1936<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">DOI: 10.1056\/NEJMicm2408573<\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.nejm.org\/cms\/10.1056\/NEJMicm2408573\/asset\/be5967a5-65e7-4738-97c4-c7b6792b7b82\/assets\/images\/large\/nejmicm2408573_f1.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<p>A 50-year-old man presented with a 1-year history of progressive headaches and nausea. On physical examination, neck stiffness and dysmetria in both arms on finger-to-nose testing were noted. Results of a lumbar puncture revealed an opening pressure of 31 cm of water (reference range, 7 to 20), and cerebrospinal fluid studies were notable for elevations in the protein level and immunoglobulin index. Subsequent contrast-enhanced, T1-phase magnetic resonance imaging (MRI) of the head showed thickened dura with central hypointensity and peripheral enhancement at the posterior falx and cerebellar tentorium \u2014 a finding known as Eiffel-by-night sign (coronal view). Eiffel-by-night sign is thought to represent active inflammation of chronic pachymeningitis and may be seen in the context of inflammatory, autoimmune, neoplastic, or vascular conditions. A dural biopsy showed a lymphoplasmacytic infiltrate with IgG4-positive plasma cells. The serum IgG4 level was elevated. Whole-body imaging showed no other organ involvement. A diagnosis of IgG4-related hypertrophic pachymeningitis was made. Treatment was initiated with methylprednisolone pulse therapy for 5 days and was then transitioned to a slowly tapering dose of oral glucocorticoids. At a 2-month follow-up visit, a repeat MRI of the head showed improvement, and at 6 months, the patient\u2019s headache had abated. A maintenance dose of a glucocorticoid was continued.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>IMAGES IN CLINICAL MEDICINE Eiffel-by-Night Sign Kundia [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[16,13],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27275"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27275"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27275\/revisions"}],"predecessor-version":[{"id":27276,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27275\/revisions\/27276"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27275"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27275"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27275"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}