title: [Granulomatous meningitis, crescentic glomerulonephritis and vasculitis].
abstract: Meningeal involvement is an infrequent manifestation of Wegener's granulomatosis. Clinical manifestations can be headache with high protein level in the cerebrospinal fluid and an enhanced MRI signal of granulomatous thickening of the duramater in the brain. We report a 57 year-old male with Wegener granulomatosis with onset manifestations of asymptomatic granulomatous meningitis, upper respiratory tract, ears and orbits involvement. He progressively developed ANCA positive multiple mononeuritis and crescentic glomerulonephritis. The diagnostic confirmation of Wegener's granulomatosis based on a positive ANCA test and on the evidence of systemic disease (crescentic glomerulonephritis and involvement of the upper respiratory tract, ears, orbits, peripheral nerves and duramater) allowed a prompt initiation of aggressive immunosuppressive treatment with systemic cyclophosphamide and high - dosis corticosteroids. The patient entered into a sustained clinical remission with mild residual neurosensorial hearing loss and renal failure.
authors: Servicio de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. ana_luduena@hotmail.com
authors: Ana
authors: A
authors: Ludueña
authors: Enrique
authors: E
authors: Dorado
authors: Judith
authors: J
authors: Sarano
authors: Guillermo
authors: G
authors: Semeniuk
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D005921:Glomerulonephritis / Q000209:etiology*; D006099:Granuloma / Q000209:etiology*; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology*; D008875:Middle Aged
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic