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A 64-year-old woman presented to our hospital with a 2-week history of visual disturbance and headaches. She was diagnosed as having retroperitoneal fibrosis and being in remission for 2 years. Examination revealed left homonymous hemianopsia, but her pupil reaction was normal. She neither had a fever nor neck stiffness. Her white blood cell count, D-dimer, prothrombin time and activated partial thromboplastin time were within normal range and C reactive protein was 1.5 mg/L (normal<1.4). Serum immunoglobulin G4 (IgG4) levels were 43.7 mg/dL (normal 4.8–105.0) and tests for anti-neutrophil cytoplasmic antibody (ANCA) were negative. Cerebrospinal …
Handling editor Josef S Smolen
Contributors KA and YF conceptualised the case report. KA collected case data and drafted the manuscript. YF and TA reviewed and revised the manuscript. All authors approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.