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J Clin Rheumatol ; 28(3): e672-e674, 2022 Apr 01.
Article in English | MEDLINE | ID: mdl-35325906

ABSTRACT

ABSTRACT: A 65-year-old man with no pertinent medical history presented with 1 month of progressive holocephalic positional headaches (worse supine), photophobia, progressive gait instability resulting in multiple falls (ambulatory to walker in only 2 months), and weight loss. Testing found positive ANCA 1:160 perinuclear patter, myeloperoxidase >8.0. Cerebrospinal fluid found lymphocytic pleocytosis. We present his neuroimaging of isolated hypertrophic pachymeningitis with clinicoradiographic resolution after immunomodulatory pharmacotherapy along with histology from his meningeal biopsy. Isolated vasculitic myeloperoxidase-antineutrophil cytoplasmic antibody hypertrophic pachymeningitis is quite rare.


Subject(s)
Meningitis , Vasculitis , Aged , Antibodies, Antineutrophil Cytoplasmic , Humans , Hypertrophy , Male , Meningitis/diagnosis , Meningitis/etiology , Peroxidase
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