Hypertrophic pachymeningitis with MPO-ANCA-positive vasculitis.
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.
Horino
Taro
T
Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Okoh-cho, Nankoku-shi, Kochi, 783-8505, Japan. horinott@yahoo.co.jp
Takao
Toshihiro
T
Taniguchi
Yoshinori
Y
Terada
Yoshio
Y
D000284:Administration, Oral; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000187:drug effects / Q000276:immunology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004388:Dura Mater / Q000000981:diagnostic imaging; D006261:Headache / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008775:Methylprednisolone / Q000008:administration & dosage; D009195:Peroxidase / Q000187:drug effects / Q000276:immunology*; D011239:Prednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D011859:Radiography; D014657:Vasculitis / Q000150:complications / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D009195:Peroxidase; D008775:Methylprednisolone