Unusual visual impairments in a case of MPO-ANCA associated hypertrophic pachymeningitis
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- Hayashi Seiya
- Department of Neurology, Tohoku University School of Medicine
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- Sugeno Naoto
- Department of Neurology, Tohoku University School of Medicine
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- Nishiyama Syuhei
- Department of Neurology, Tohoku University School of Medicine
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- Hasegawa Takafumi
- Department of Neurology, Tohoku University School of Medicine
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- Aoki Masashi
- Department of Neurology, Tohoku University School of Medicine
Bibliographic Information
- Other Title
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- 両眼性の視力障害をきたしたMPO-ANCA関連肥厚性硬膜炎の1例
- 症例報告 両眼性の視力障害をきたしたMPO-ANCA関連肥厚性硬膜炎の1例
- ショウレイ ホウコク リョウ ガンセイ ノ シリョク ショウガイ オ キタシタ MPO-ANCA カンレン ヒコウセイコウマクエン ノ 1レイ
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Abstract
We report a 79-year-old man presenting MPO-ANCA associated hypertrophic pachymeningitis and bilateral visual impairment. Two years before, microscopic hematuria and positive MPO-ANCA were indicated, then oral steroids and cyclophosphamide were given as systemic vasculitis. On admission, lateral hemianopsia in the right visual field was documented. Some weeks after admission, he complained of a left-hand side headache, and the visual impairment of a right eye. Brain MRI detected thick dura matter with abnormal enhancement predominantly on the left side of the basal temporal lobe and a tumor-like lesion at the sphenoid sinus near the right cavernous sinus. Multiple scotomas in the left visual field were compatible with ischemic changes caused by MPO-ANCA related vasculitis. On the other hand, the hemianopsia in his right eye was related with a tumor-like lesion. The visual problems showed a favorable response to the steroid pulse therapy. ANCA-positive cases can demonstrate various symptoms including intra-/extra-cranial involvement. Thus, thorough clinical workup is needed to determine the actual site of the lesion when cranial nerve involvement is observed in MPO-ANCA positive hypertrophic pachymeningitis.<br>
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 52 (3), 152-155, 2012
Societas Neurologica Japonica
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Details 詳細情報について
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- CRID
- 1390282680014065024
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- NII Article ID
- 40019232463
- 130004505250
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- NII Book ID
- AN00253207
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- COI
- 1:STN:280:DC%2BC38rgtVemsg%3D%3D
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- ISSN
- 18820654
- 0009918X
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- NDL BIB ID
- 023590688
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- PubMed
- 22453038
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed