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
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- Kaieda Shinjiro
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Yoshida Naomi
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Minezaki Midori
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Ushijima Shuri
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Wakasugi Daisuke
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Miura Shiroh
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Uchiyama Yusuke
- Department of Radiology, Kurume University School of Medicine, Japan
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- Ida Hiroaki
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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- Hoshino Tomoaki
- Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan
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説明
<p>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. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 56 (8), 959-965, 2017
一般社団法人 日本内科学会
