A case report of hypertrophic pachymeningitis associated with systemic lupus erythematosus, showing a headache and hearing loss resembling intracranial hypotension] |
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Authors: | Sae Ochi Toshihiro Nanki Yukiko Komano Fumihito Suzuki Jun Ogawa Takehiko Sugihara Kenji Nagasaka Yoshinori Nonomura Hiroyuki Hagiyama Nobuyuki Miyasaka |
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Institution: | Department of Medicine and Rheumatology, Tokyo Medical and Dental University. |
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Abstract: | We report a case of systemic lupus erythematosus (SLE) complicated with hypertrophic pachymeningitis. A 34-year old woman who was diagnosed as SLE in 1985 was admitted to our hospital for a high grade fever and a headache. Laboratory findings showed increased titer of anti-double strand DNA antibody and decreased number of platelets. She complained a severe headache and hearing loss which were worsened by head-up position, resembling the symptoms of intracranial hypotension. MRI findings revealed thickened dura and she was diagnosed as hypertrophic pachymeningitis. Both clinical symptoms and laboratory findings were resolved after methyl-prednisolone pulse therapy followed by a high dose of prednisolone. Although hypertrophic pachymeningitis is a rare complication with SLE, it should be considered in SLE patients with severe headache. |
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