title: [A case report of hypertrophic pachymeningitis associated with systemic lupus erythematosus, showing a headache and hearing loss resembling intracranial hypotension].
abstract: We report a case of systemic lupus erythematosus (SLE) complicated with hypertrophic pachymeningitis. A 34-year old woman who was diagnosed as SLE in 1985 was admitted to our hospital for a high grade fever and a headache. Laboratory findings showed increased titer of anti-double strand DNA antibody and decreased number of platelets. She complained a severe headache and hearing loss which were worsened by head-up position, resembling the symptoms of intracranial hypotension. MRI findings revealed thickened dura and she was diagnosed as hypertrophic pachymeningitis. Both clinical symptoms and laboratory findings were resolved after methyl-prednisolone pulse therapy followed by a high dose of prednisolone. Although hypertrophic pachymeningitis is a rare complication with SLE, it should be considered in SLE patients with severe headache.
authors.affiliation: Department of Medicine and Rheumatology, Tokyo Medical and Dental University.
authors.forename: Sae
authors.initials: S
authors.lastname: Ochi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nanki
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Komano
authors.forename: Fumihito
authors.initials: F
authors.lastname: Suzuki
authors.forename: Jun
authors.initials: J
authors.lastname: Ogawa
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sugihara
authors.forename: Kenji
authors.initials: K
authors.lastname: Nagasaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nonomura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hagiyama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyasaka
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000209:etiology; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D006984:Hypertrophy; D019585:Intracranial Hypotension / Q000175:diagnosis*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis*; D008581:Meningitis / Q000209:etiology* / Q000473:pathology