Hypertrophic pachymeningitis with MPO-ANCA-positive vasculitis

Clin Rheumatol. 2010 Jan;29(1):111-3. doi: 10.1007/s10067-009-1269-x. Epub 2009 Sep 2.

Abstract

A 75-year-old man presented with headache, right facial palsy, and left hemiparesis. Because of elevated myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) titers and findings from magnetic resonance imaging (MRI) which were compatible with hypertrophic pachymeningitis (HP), he was diagnosed with MPO-ANCA-positive HP. He was treated with the combination therapy of steroid and cyclophosphamide (CY), leading to good prognosis. We present a case of HP associated with MPO-ANCA-positive vasculitis and emphasize the importance of MPO-ANCA tests as a predictable factor for relapse of the disease in order to start earlier treatment for the disease.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / drug effects
  • Antibodies, Antineutrophil Cytoplasmic / immunology*
  • Cyclophosphamide / administration & dosage
  • Drug Therapy, Combination
  • Dura Mater / diagnostic imaging
  • Headache / etiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Meningitis / cerebrospinal fluid
  • Meningitis / complications
  • Meningitis / diagnosis
  • Meningitis / drug therapy
  • Meningitis / immunology*
  • Methylprednisolone / administration & dosage
  • Peroxidase / drug effects
  • Peroxidase / immunology*
  • Prednisolone / administration & dosage
  • Pulse Therapy, Drug
  • Radiography
  • Vasculitis / complications
  • Vasculitis / immunology*

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Immunosuppressive Agents
  • Cyclophosphamide
  • Prednisolone
  • Peroxidase
  • Methylprednisolone