title: Pachymeningitis and cerebral granuloma in granulomatosis with polyangiitis: is rituximab a promising treatment option?
abstract: Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease characterized by granulomatous inflammation involving upper and lower respiratory tract, kidneys and peripheral nervous system. However, central nervous system involvement is uncommon and frequently refractory to classical therapy. Rituximab has emerged as promising alternative, but published reports are scarce. We report a case of pachymeningitis and cerebral granuloma in a patient with a history of severe generalized GPA, treated with rituximab. This case illustrates the complexity of the management of neurologic manifestations and provides insight into the potential utility of rituximab in this condition.
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: Carlos
authors.initials: C
authors.lastname: Costa
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: Tânia
authors.initials: T
authors.lastname: Santiago
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: Joana
authors.initials: J
authors.lastname: Espirito-Santo
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: João
authors.initials: J
authors.lastname: Rovisco
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: Jorge
authors.initials: J
authors.lastname: Silva
authors.affiliation: Centro Hospitalar e Universitário de Coimbra.
authors.forename: Armando
authors.initials: A
authors.lastname: Malcata
mesh_terms: D001927:Brain Diseases / Q000188:drug therapy* / Q000209:etiology; D006099:Granuloma / Q000188:drug therapy* / Q000209:etiology; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D000069283:Rituximab / Q000627:therapeutic use*
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab