title: Cerebral pachyleptomeningitis associated with MPO-ANCA induced by PTU therapy.
abstract: A 34-year-old woman with hyperthyroidism, who had been previously treated with propylthiouracil (PTU) is reported. She was admitted because of clumsiness in her left hand and abnormal behavior. A neurological examination demonstrated impairment of higher cortical function, and weakness and hyperreflexia of the left leg. An MRI scan with gadolinium enhancement showed pachyleptomeningeal thickening in the right frontoparietal lobe. Blood tests revealed a high MPO-ANCA titer of 122 EU (normal:<10 EU). After steroid administration, the neurological symptoms and the MRI findings improved markedly. This is the first report of PTU-induced cerebral pachyleptomeningitis associated with a high serum MPO-ANCA titer.
authors.affiliation: Neurology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takato
authors.initials: T
authors.lastname: Abe
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nogawa
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Eiji
authors.initials: E
authors.lastname: Ikeda
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001099:Arachnoid / Q000473:pathology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008581:Meningitis / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D009195:Peroxidase / Q000097:blood*; D010841:Pia Mater / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D005938:Glucocorticoids; D011441:Propylthiouracil; D003907:Dexamethasone; D011239:Prednisolone; D009195:Peroxidase