title: Hypertrophic cranial pachymeningitis in MPO-ANCA-related vasculitis: a case report and literature review.
abstract: A 75-year-old woman presented with rapidly progressive glomerulonephritis with positive results for anti-myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). Corticosteroid therapy was successfully introduced. However, 7 months later, magnetic resonance imaging revealed marked swelling in the falx cerebri and high density regions were apparent on gallium scintigraphy, leading to diagnosis of hypertrophic cranial pachymeningitis (HCP). Symptoms improved with intensified corticosteroid therapy, but radiological examination 9 months later revealed right nasal sinus inflammation accompanied by osteolytic change. Granulomatosis with polyangiitis (Wegener's) was finally diagnosed. HCP is an important complication in MPO-ANCA-related vasculitis, and needs to be considered during the clinical course.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan. ag9t2wja@fmu.ac.jp
authors.forename: Kimio
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Jun
authors.initials: J
authors.lastname: Asai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D006984:Hypertrophy; D008581:Meningitis / Q000209:etiology*; D009195:Peroxidase / Q000276:immunology*
chemical_list: D009195:Peroxidase