title: [A case of MPO-ANCA positive hypertrophic pachymeningitis associated with vascular inflammation in the kidney biopsy].
abstract: We report a 76-year-old male with ANCA-associated hypertrophic pachymeningitis, who presented with crescentic glomerulonephritis. At the initial visit, he had episodic frontal headache and multiple cranial nerve palsy, including double vision, right deafness, hoarseness, and dysphagia. Because proteinuria and hematuria were detected on urinalysis, we performed a kidney biopsy, leading to the diagnosis of crescentic glomerulonephritis. The presence of vascular inflammation in the kidney biopsy led us to consider that this patient may show progression to the systemic type of MPO-ANCA-positive hypertrophic pachymeningitis. This proved useful for prognostic and treatment determination. Based on the results of laboratory tests, imaging studies, and biopsies of the dura mater and kidney, the patient was diagnosed with ANCA-associated hypertrophic pachymeningitis.
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine.
authors.forename: Daiki
authors.initials: D
authors.lastname: Takewaki
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Takashi
authors.initials: T
authors.lastname: Kasai
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Yoshida
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D001706:Biopsy; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000276:immunology*; D014657:Vasculitis / Q000473:pathology*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic