Hypertrophic pachymeningitis as an initial and cardinal manifestation of microscopic polyangiitis

Abstract

The authors describe a 68-year-old man who developed hypertrophic pachymeningitis as an initial and cardinal manifestation of microscopic polyangiitis. The patient had a high titer of antineutrophil cytoplasmic antibody for myeloperoxidase. Biopsies revealed necrotizing glomerulonephritis in the kidney, small vessel vasculitis in the sural nerve, and infiltration of plasma cells and eosinophils in the thickened dura mater.