title: Wegener's granulomatosis presenting with pachymeningitis: clinical and imaging remission by rituximab.
abstract: A 27-year-old woman was admitted for intractable right-sided neck, ear, and jaw pain with gradual development of tinnitus and hearing loss. A cerebral MRI showed meningo-dural enhancement, and additional diagnostic workup revealed a right pulmonary infiltrate and positive PR-3 ANCA. Biopsies from nasal mucosa and lung showed chronic inflammation with granuloma formation. Based on these findings the patient was diagnosed with Wegener's granulomatosis with pachymeningitis. There was no clinical response to oral Prednisolone and Cyclophosphamide, but complete clinical and imaging remission was achieved by adding Rituximab.
authors.affiliation: Department of Internal Medicine, Odense University Hospital, Valdemarsgade 53, 5700 Svendborg, Denmark.
authors.forename: Søren Andreas
authors.initials: SA
authors.lastname: Just
authors.forename: John Bonde
authors.initials: JB
authors.lastname: Knudsen
authors.forename: Mie Kiszka
authors.initials: MK
authors.lastname: Nielsen
authors.forename: Peter
authors.initials: P
authors.lastname: Junker