Koura Tomoyuki, Kita Keiichiro, Konishi Hirofumi
Department of Toyama Primary Care University of Toyama School of Medicine Toyama Japan.
Department of General Medicine Toyama University Hospital Toyama Japan.
J Gen Fam Med. 2017 Sep 15;18(6):409-410. doi: 10.1002/jgf2.73. eCollection 2017 Dec.
A 66-year-old man presented to our emergency department with acute consciousness disorder, headache, and fever. Initial laboratory data indicated a high level of inflammatory reaction. Enhanced magnetic resonance imaging revealed a thickening of the right cranial dura mater on T1-weighted images. We presumed the patient was diagnosed as having myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-related hypertrophic pachymeningitis (HP). Acute impaired consciousness without focal signs is an unusual presentation of HP. This treatable disease should be considered as a differential diagnosis when a patient presents with drowsiness and headache.
一名66岁男性因急性意识障碍、头痛和发热前来我院急诊科就诊。初始实验室数据显示炎症反应水平较高。增强磁共振成像显示T1加权图像上右侧硬脑膜增厚。我们推测该患者被诊断为髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）相关肥厚性硬脑膜炎（HP）。无局灶性体征的急性意识障碍是HP的一种不寻常表现。当患者出现嗜睡和头痛时，应考虑将这种可治疗的疾病作为鉴别诊断。
