TY - JOUR
T1 - Combined Hypertrophic Pachymeningitis and Cerebral Venous Thrombosis in a Case of Granulomatosis with Polyangiitis
AU - Kuribayashi, Tadahiro
AU - Manabe, Yasuhiro
AU - Fujiwara, Shunya
AU - Omote, Yoshio
AU - Narai, Hisashi
AU - Abe, Koji
N1 - Publisher Copyright:
© 2019 The Author(s). Published by S. Karger AG, Basel.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - We report a rare case of hypertrophic pachymeningitis (HP) and cerebral venous thrombosis associated with proteinase-3-antineutrophil cytoplasmic antibody (PR3-ANCA)-positive granulomatosis with polyangiitis (GPA). A 58-year-old male developed left headache after exudative otitis media. The laboratory data were positive for PR3-ANCA. Brain magnetic resonance imaging revealed bilateral paranasal sinusitis, left frontal lobe edema, and a thick dura mater with abnormal enhancement in the frontotemporal lobe. Magnetic resonance venography detected stenosis of the superior sagittal sinus. The patient was successfully treated with glucocorticoid, cyclophosphamide, and apixaban. Contrast neuroimaging should be performed for patients who present with unexplained headache, especially with middle ear and paranasal inflammation. These symptoms should be considered as GPA-related HP and cerebral venous thrombosis.
AB - We report a rare case of hypertrophic pachymeningitis (HP) and cerebral venous thrombosis associated with proteinase-3-antineutrophil cytoplasmic antibody (PR3-ANCA)-positive granulomatosis with polyangiitis (GPA). A 58-year-old male developed left headache after exudative otitis media. The laboratory data were positive for PR3-ANCA. Brain magnetic resonance imaging revealed bilateral paranasal sinusitis, left frontal lobe edema, and a thick dura mater with abnormal enhancement in the frontotemporal lobe. Magnetic resonance venography detected stenosis of the superior sagittal sinus. The patient was successfully treated with glucocorticoid, cyclophosphamide, and apixaban. Contrast neuroimaging should be performed for patients who present with unexplained headache, especially with middle ear and paranasal inflammation. These symptoms should be considered as GPA-related HP and cerebral venous thrombosis.
KW - Antineutrophil cytoplasmic antibody
KW - Central nervous system
KW - Cerebral venous thrombosis
KW - Granulomatosis with polyangiitis
KW - Hypertrophic pachymeningitis
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U2 - 10.1159/000502284
DO - 10.1159/000502284
M3 - Article
AN - SCOPUS:85074533450
SN - 1662-680X
VL - 11
SP - 252
EP - 255
JO - Case Reports in Neurology
JF - Case Reports in Neurology
IS - 2
ER -