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J Neurol Sci. 2014 Sep 15;344(1-2):208-9. doi: 10.1016/j.jns.2014.06.052. Epub 2014 Jun 30.

Granulomatosis with polyangiitis presenting with pachymeningitis.

Author information

1
Wake Forest School of Medicine, United States.
2
Department of Neurology, Wake Forest School of Medicine, United States. Electronic address: nbalakri@wakehealth.edu.
3
Department of Neurology, Wake Forest School of Medicine, United States.

Abstract

OBSERVATIONS:

This case report describes a 75 year-old Caucasian male who initially presented with persistent daily headaches. Physical exam elicited multiple cranial nerve palsies. Gadolinium-enhanced brain MRI demonstrated pachymeningitis. Labs revealed elevated proteinase-3 antineutrophil cytoplasmic antibodies (PR3-ANCA) and cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA), confirming a diagnosis of GPA.

CONCLUSION:

GPA should be considered in older patients presenting with persistent daily headaches and pachymeningitis. Contrast-enhanced brain MRI is an important diagnostic tool.

KEYWORDS:

Cranial neuropathy; Granulomatosis with polyangiitis; Headache; MRI; Pachymeningitis; Wegener's granulomatosis

PMID:
25052727
DOI:
10.1016/j.jns.2014.06.052
[Indexed for MEDLINE]
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