Bosman T, Simonin C, Launay D, Caron S, Destée A, Defebvre L
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands,
Rheumatol Int. 2008 May;28(7):713-8. doi: 10.1007/s00296-007-0504-5. Epub 2007 Dec 19.
Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare clinical entity, characterized by a chronic inflammation causing thickening of the dura. Adequate therapeutic management is still a matter of debate. We present a patient with an IHCP, non-responsive to corticotherapy. Oral methotrexate was introduced (12.5 mg weekly) and total remission was observed after 6 weeks, both clinically and after neuro-imaging. We conclude that methotrexate can be effective and a therapeutical option in patients with IHCP who are resistant to corticotherapy or present major side-effects of chronic corticosteroids use.
特发性肥厚性硬脑膜炎（IHCP）是一种罕见的临床病症，其特征为慢性炎症导致硬脑膜增厚。充分的治疗管理仍是一个有争议的问题。我们报告了一名对皮质激素治疗无反应的IHCP患者。开始口服甲氨蝶呤（每周12.5毫克），6周后在临床和神经影像学检查中均观察到完全缓解。我们得出结论，对于对皮质激素治疗耐药或出现长期使用皮质类固醇激素的主要副作用的IHCP患者，甲氨蝶呤可能有效且是一种治疗选择。
