https://doi.org/10.4081/reumatismo.2013.248

Multiple cranial nerve palsy revealing hypertrophic pachymeningitis with positive myeloperoxidase-antineutrophil cytoplasmic antibody

Vol. 65 No. 5 (2013)
Submitted: 25 July 2013
Accepted: 7 November 2013
Published: 18 December 2013
Hypertrophic pachymeningitis, Antineutrophil cytoplasmic antibodies.
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Authors

S. El Aoud
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
F. Frikha
fetenfrikha@yahoo.fr
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
R. Ben Salah
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
M. Snoussi
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
H. Loukil
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
Z. Bahloul
Department of Internal Medicine, Hedi Chaker Hospital, Tunisia.
Pachymeningitis is a progressive disease resulting in a diffuse thickening of dura mater due to inflammation, tumor or autoimmune diseases, but most cases are idiopathic. Here, we report the case of a 60-year old man who had a progressive sensorineural hearing loss, visual disturbance and others cranial nerve involvement with an accompanying headache over several months. Brain magnetic resonance imaging showed diffusely thickened dura mater, highly enhanced after gadolinium administration, which was consistent with pachymeningitis. It was assumed to be related to autoimmune pathogenesis on the basis of elevated serum myeloperoxidase-antineutrophil cytoplasmic antibody titers. After empirical steroid and cyclophosphamide therapy, the neurological problems were partially improved. Therefore, in the case of atypical sensorineural hearing loss accompanied by cranial nerve palsy or headache, pachymeningitis should be considered in the differential diagnosis.

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How to Cite

El Aoud, S., Frikha, F., Ben Salah, R., Snoussi, M., Loukil, H., & Bahloul, Z. (2013). Multiple cranial nerve palsy revealing hypertrophic pachymeningitis with positive myeloperoxidase-antineutrophil cytoplasmic antibody. Reumatismo, 65(5), 248–252. https://doi.org/10.4081/reumatismo.2013.248

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