From the Departments of Neurology.
Pathology.
J Clin Rheumatol. 2022 Apr 1;28(3):e672-e674. doi: 10.1097/RHU.0000000000001845.
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.
一位 65 岁的男性，无相关病史，表现为 1 个月进行性全颅位头痛（仰卧位时更严重）、畏光、进行性步态不稳导致多次跌倒（仅 2 个月内从能行走进展至需使用助行器）和体重减轻。检查发现抗中性粒细胞胞浆抗体 1:160 核周型阳性，髓过氧化物酶>8.0。脑脊液检查发现淋巴细胞增多。我们报告了他孤立性肥厚性硬脑膜炎的神经影像学表现，经免疫调节药物治疗后临床和影像学均缓解，同时也报告了脑膜活检的组织学结果。孤立性血管炎、髓过氧化物酶-抗中性粒细胞胞浆抗体阳性、肥厚性硬脑膜炎非常罕见。
