title: Wegener's granulomatosis with dural involvement as the initial clinical manifestation.
abstract: We treated a patient with an atypical presentation of Wegener's granulomatosis (WG) with dural involvement as the initial clinical manifestation. A 37-year-old man had a dural lesion without lower respiratory tract or renal manifestations in the initial clinical course. His only initial symptom was headache, and at disease onset computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed bilateral abnormal subdural masses. The diagnosis of WG was made based on the results of needle biopsy of the nasal polyps and the finding of positive circulating antineutrophil cytoplasmic antibodies (c-ANCA). He achieved remission on daily prednisone and cyclophosphamide with the later addition of sulfamethoxazole-trimethoprim.
authors.affiliation: Second Department of Internal Medicine, Wakayama Medical College, Bancho.
authors.forename: A
authors.initials: A
authors.lastname: Shiotani
authors.forename: C
authors.initials: C
authors.lastname: Mukobayashi
authors.forename: H
authors.initials: H
authors.lastname: Oohata
authors.forename: T
authors.initials: T
authors.lastname: Yamanishi
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.forename: H
authors.initials: H
authors.lastname: Itoh
authors.forename: S
authors.initials: S
authors.lastname: Nishioka
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004388:Dura Mater / Q000276:immunology / Q000473:pathology*; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D006261:Headache / Q000209:etiology*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009298:Nasal Polyps / Q000209:etiology / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003520:Cyclophosphamide; D011241:Prednisone