Hypertrophic Pachymeningitis with Characteristics of Both IgG4-related Disorders and Granulomatosis with Polyangiitis
| Autor: | Shigeru Hayashi, Kenji Sakai, Takayuki Nojima, Masanao Mohri, Makoto Mori, Masahito Yamada, Katsuhiko Saito, Keitaro Matsubara |
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| Rok vydání: | 2022 |
| Předmět: |
Male
musculoskeletal diseases Pathology medicine.medical_specialty Dura mater Antibodies Antineutrophil Cytoplasmic Fibrosis parasitic diseases Biopsy Internal Medicine medicine Humans Meningitis Pathological Aged Inflammation integumentary system biology medicine.diagnostic_test business.industry Granulomatosis with Polyangiitis Hypertrophy General Medicine musculoskeletal system medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure nervous system Immunoglobulin G Myeloperoxidase biology.protein IgG4-related disease Headaches medicine.symptom Granulomatosis with polyangiitis business |
| Zdroj: | Internal Medicine. 61:1903-1906 |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.8550-21 |
| Popis: | We herein report a 73-year-old man with isolated hypertrophic pachymeningitis (HP) showing serological and pathological characteristics of both IgG4-related disorders and granulomatosis with polyangiitis. The patient presented with chronic onset headaches and ophthalmalgia. Brain magnetic resonance imaging (MRI) revealed a hypertrophic enhanced dura mater. Serum IgG4 and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) levels were elevated. A dura mater biopsy showed infiltration of numerous IgG4-positive plasma cells and granulomatous inflammation without apparent vasculitic lesions, storiform fibrosis, or obstructive phlebitis. Corticosteroid treatments improved his clinical symptoms and MRI findings. There have been reports of MPO-ANCA-positive IgG4-related HP presenting as granulomatous inflammation in the dura mater. |
| Databáze: | OpenAIRE |
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