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