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Neurology, Neuropsychiatry, Psychosomatics

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Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature)

https://doi.org/10.14412/2074-2711-2015-2-42-46

Abstract

The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI) is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

About the Authors

E. G. Mendelevich
Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia 49, Butlerov St., Kazan 420012, Republic of Tatarstan
Russian Federation


C. S. Fattakhova
Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia 49, Butlerov St., Kazan 420012, Republic of Tatarstan
Russian Federation


E. I. Bogdanov
Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia 49, Butlerov St., Kazan 420012, Republic of Tatarstan
Russian Federation


References

1. Kupersmith MJ, Martin V, Heller G, et al. Idiopathic hypertrophic pachymeningitis. Neurology. 2004 Mar 9;62(5):686–94.

2. Martin N, Masson C, Herin D, et al. Hypertrophic cranial pachymeningitis: assessment with CT and MR imaging. AJNR Am J Neuroradiol. 1989 May–Jun;10(3):477–84.

3. Lu LX, Della-Torre E, Stone JH, Clark SW. IgG4-Related Hypertrophic Pachymeningitis Clinical Features, Diagnostic Criteria, and Treatment. JAMA Neurol. 2014 Jun;71(6):785–93. doi: 10.1001/jamaneurol. 2014.243.

4. Masson C, Henin D, Hauw JJ, et al. Cranial pachymeningitis of unknown origin: a study of seven cases. Neurology. 1993 Jul;43(7):1329–34.

5. Naffziger HC, Stern WE. Chronic pachymeningitis: report of a case and review of the literature. Arch Neurol Psychiatry. 1949 Oct;62(4):383–411.

6. Пизова НВ. Головная боль при ревматических заболеваниях. Медицинский совет. 2012;(8):52–7. [Pizova NV. Headache in rheumatic diseases. Meditsinskii sovet. 2012;(8):52–7. (In Russ.)].

7. Mamelak AN, Kelly WM, Davis RL, Rosenblum ML. Idiopathic hypertrophic cranial pachymeningitis. J Neurosurg. 1993 Aug;79(2):270–6.

8. Fujimoto M, Kira J, Murai H, et al. Hypertrophic cranial pachymeningitis associated with mixed connective tissue disease; a comparison with idiopathic and infectious achymeningitis. Intern Med. 1993 Jun;32(6):510–2.

9. Седышев СХ, Васильев ВИ, Ковригина АМ, Насонов ЕЛ. IgG4-связанное системное заболевание. Современный взгляд на «старые» болезни. Научно-практическая ревматология. 2012;54(5):64–72. [Sedyshev SKh, Vasil'ev VI, Kovrigina AM, Nasonov EL. IgG4-linked systemic disease. Modern outlook on «old» disease. Nauchnoprakticheskaya revmatologiya = Rheumatology Science and Practice. 2012;54(5):64–72. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2012-1184.

10. Okazaki K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006 Jul;41(7):626–31.

11. Wallace ZS, Carruthers MN, Khosroshahi A, et al. IgG4-related disease and hypertrophic pachymeningitis. Medicine (Baltimore). 2013 Jul;92(4):206–16. doi: 10.1097/MD. 0b013e31829cce35.

12. Della-Torre E, Galli L, Franciotta D, et al. Diagnostic value of IgG4 indices in IgG4-related hypertrophic pachymeningitis. J Neuroimmunol. 2014 Jan 15;266(1–2):82–6. doi: 10.1016/j.jneuroim.2013.10.008. Epub 2013 Oct 22.

13. Lindstrom KM, Cousar JB, Lopes MB. IgG4-related meningeal disease: clinico- athological features and proposal for diagnostic criteria. Acta Neuropathol. 2010 Dec;120(6):765–76. doi: 10.1007/s00401-010-0746-2. Epub 2010 Sep 16.

14. Seror R, Mahr A, Ramanoelina J, et al. Central nervous system involvement in Wegener granulomatosis. Medicine (Baltimore). 2006 Jan;85(1):54–65.

15. Di Comite G, Bozzolo EP, Praderio L, et al. Meningeal involvement in Wegener's ranulomatosis is associated with localized disease. Clin Exp Rheumatol. 2006 Mar–Apr;24(2 Suppl 41):S60–4.

16. Eto F, Shimada Y, Endo H, Mozai T. Wegener’s granulomatosis with marked pachymeningitis — an autopsy study. Rinsho Shinkeigaku. 1976 Apr;16(4):326–32.

17. Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum. 1990 Aug;33(8):1101–7.

18. Kuhn J, Weber M, Hedde JP, Bewermeyer H. Atypical headache and facial pain as a result of hypertrophic pachymeningitis in C-ANCApositive Wegener's granulomatosis. Med Klin (Munich). 2005 Apr 15;100(4):209–12.


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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)