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- W4288068104 abstract "A 63-year-old man complained of gradually worsening headache. He had been diagnosed 6 years ago with MPO-ANCA-positive ANCA-associated vasculitis (AAV) with rapidly progressive glomerulonephritis, iritis and otitis media. After induction therapy with glucocorticoid pulse and subsequent maintenance therapy, he had relapsed twice with elevation of MPO-ANCA titre. On admission, his headache was accompanied by right hearing disorder and right facial paralysis, and CRP was increased to 10.2 mg/dl. Other manifestations of AAV were not identified, and MPO-ANCA was negative. Head MRI revealed thickening dura with contrast effect from the right middle cranial fossa to the cerebellum tent (Fig. 1A). Consistently, 67Gallium scintigraphy showed abnormal accumulation in the cerebral falx to the cerebellum tent (Fig. 1B). We performed a lumbar puncture and diagnosed him with hypertrophic pachymeningitis (HP). HP is a rare disease characterized by inflammation and fibrotic thickening dura mater which can be idiopathic or secondary to a variety of conditions, such as infections, malignancies or rheumatic diseases [1]. AAV-associated HP often develops without other manifestations of AAV nor ANCA elevation [2]. Treatment with prednisolone 55 mg/day and rituximab improved his symptoms and imaging findings (Fig. 1C). 67Gallium scintigraphy may be useful to detect active inflammation of the dura mater." @default.
- W4288068104 created "2022-07-28" @default.
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- W4288068104 date "2022-07-27" @default.
- W4288068104 modified "2023-10-16" @default.
- W4288068104 title "Hypertrophic pachymeningitis in anti-neutrophil cytoplasmic antibody-associated vasculitis detected by 67Gallium scintigraphy" @default.
- W4288068104 cites W2279466036 @default.
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- W4288068104 doi "https://doi.org/10.1093/rheumatology/keac395" @default.
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