TY - JOUR
T1 - Hypertrophic pachymeningitis in a patient with ANCA negative granulomatosis with polyangiitis
T2 - A case report
AU - Huaringa-Marcelo, Jorge
AU - Tapia-Orihuela, Rubén Kevin Arnold
AU - Loja-Oropeza, David
N1 - Publisher Copyright:
© 2020 Asociación Colombiana de Reumatología
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Granulomatosis with polyangiitis (GPA) is a vasculitic disease with an infrequent involvement of the central nervous system. This can lead, in rare cases, to hypertrophic pachymeningitis (HP), which is characterized by inflammation and fibrosis that cause a thickening of dura mater. At present, it is crucial to consider GPA in the differential diagnosis of elderly patients with intracranial hypertension. The case is presented of a 60-year-old male with progressive severe headache, vomiting, and wasting syndrome. Physical examination showed pallor, weight loss, and unilateral papilloedema. A gadolinium-enhanced brain MRI scan showed sinusitis, chronic otomastoiditis, and hypertrophic pachymeningitis. Finally, a meningeal biopsy concluded a necrotising granulomatous vasculitis compatible with GPA. However, PR3- and MPO-ANCA were negative. After corticosteroid therapy was initiated, the patient had a favorable outcome during his hospital stay.
AB - Granulomatosis with polyangiitis (GPA) is a vasculitic disease with an infrequent involvement of the central nervous system. This can lead, in rare cases, to hypertrophic pachymeningitis (HP), which is characterized by inflammation and fibrosis that cause a thickening of dura mater. At present, it is crucial to consider GPA in the differential diagnosis of elderly patients with intracranial hypertension. The case is presented of a 60-year-old male with progressive severe headache, vomiting, and wasting syndrome. Physical examination showed pallor, weight loss, and unilateral papilloedema. A gadolinium-enhanced brain MRI scan showed sinusitis, chronic otomastoiditis, and hypertrophic pachymeningitis. Finally, a meningeal biopsy concluded a necrotising granulomatous vasculitis compatible with GPA. However, PR3- and MPO-ANCA were negative. After corticosteroid therapy was initiated, the patient had a favorable outcome during his hospital stay.
KW - Granulomatosis with polyangiitis
KW - Hypertrophic pachymeningitis
KW - Intracranial hypertension
KW - Vasculitis
UR - http://www.scopus.com/inward/record.url?scp=85081680945&partnerID=8YFLogxK
U2 - 10.1016/j.rcreu.2019.06.003
DO - 10.1016/j.rcreu.2019.06.003
M3 - Artículo
AN - SCOPUS:85081680945
SN - 0121-8123
VL - 27
SP - 291
EP - 297
JO - Revista Colombiana de Reumatologia
JF - Revista Colombiana de Reumatologia
IS - 4
ER -