The Successful Treatment of Myeloperoxidase Antineutrophil Cytoplasmic Antibody-positive Hypertrophic Pachymeningitis in Patients with the Limited Form of Granulomatosis with Polyangiitis Using Methotrexate: Two Case Reports
نویسندگان
چکیده
Recent findings have indicated a close relationship between myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-positive hypertrophic pachymeningitis and the limited form of granulomatosis with polyangiitis (GPA). In Japan, MPO-ANCA-positive hypertrophic pachymeningitis predominantly occurs in elderly individuals. We herein describe the cases of two patients with MPO-ANCA-positive hypertrophic pachymeningitis associated with the limited form of GPA who were successfully treated with a combination of corticosteroids and methotrexate. Although methotrexate has been shown to be less effective than cyclophosphamide for inducing the remission of GPA in patients with organ-threatening diseases, its safety and efficacy may make it a useful alternative treatment modality for patients with the limited form of GPA who show meningeal involvement.
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Resident & Fellow Rounds.
Teaching NeuroImages: Myeloperoxidase–anti-neutrophil cytoplasmic antibody–positive hypertrophic pachymeningitis A woman in her 40s presents with painless monocular vision loss and is found to have optic perineuritis and dural thickening. Comprehensive laboratory testing,MRI of the brain, and dural biopsy reveal a diagnosis of myeloperoxidase–antineutrophil cytoplasmic antibody–positive hypertr...
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