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Published in: Rheumatology International 7/2006

01-05-2006 | Case Report

Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis

Author: Jane W. Chan

Published in: Rheumatology International | Issue 7/2006

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Abstract

This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate (ESR) and C-reactive protein (CRP). Both temporal artery biopsies were negative. Neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.
Literature
1.
go back to reference Gonzalez-guy MA, Garcia-Porrua C, Gonzalez-Louzao C, Rodriguez-Ledo P, Llorea J (2001) Biopsy-negative giant cell arteritis: clinical spectrum and predictive factors for positive temporal artery biopsy. Semin Arthritis Rheum 30:249–256CrossRefPubMed Gonzalez-guy MA, Garcia-Porrua C, Gonzalez-Louzao C, Rodriguez-Ledo P, Llorea J (2001) Biopsy-negative giant cell arteritis: clinical spectrum and predictive factors for positive temporal artery biopsy. Semin Arthritis Rheum 30:249–256CrossRefPubMed
2.
go back to reference Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128PubMedCrossRef Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128PubMedCrossRef
3.
go back to reference Lam BL, Barrett DA, Glaser JS, Schatz NJ, Brown HH (1994) Visual loss from idiopathic intracranial pachymeningitis. Neurology 44(4):694–698PubMed Lam BL, Barrett DA, Glaser JS, Schatz NJ, Brown HH (1994) Visual loss from idiopathic intracranial pachymeningitis. Neurology 44(4):694–698PubMed
4.
go back to reference Tajima Y, Miyazaki Y, Sudoh K, Matumoto A (2002) Intracranial hypertrophic pachymeningitis with high perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) occurred in a patient on hemodialysis. Rinsho Shinkeigaku 42(3):243–246PubMed Tajima Y, Miyazaki Y, Sudoh K, Matumoto A (2002) Intracranial hypertrophic pachymeningitis with high perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) occurred in a patient on hemodialysis. Rinsho Shinkeigaku 42(3):243–246PubMed
5.
go back to reference Shintani S, Shiigai T, Tsuruoka S (1993) Hypertrophic cranial pachymeningitis causing progressive unilateral blindness: MR findings. Clin Neurol Neurosurg 95(1):65–70PubMedCrossRef Shintani S, Shiigai T, Tsuruoka S (1993) Hypertrophic cranial pachymeningitis causing progressive unilateral blindness: MR findings. Clin Neurol Neurosurg 95(1):65–70PubMedCrossRef
6.
go back to reference Horinouchi H, Mori T, Ueyama H, Kimoto K, Imaizumi M, Kumamoto T, Tsuda T (2000) [A case of chronic hypertrophic cranial pachymeningitis causing cranial polyneuropathy and unilateral central retinal vein occlusion]. Rinsho Shinkeigaku 40(9):937–940PubMed Horinouchi H, Mori T, Ueyama H, Kimoto K, Imaizumi M, Kumamoto T, Tsuda T (2000) [A case of chronic hypertrophic cranial pachymeningitis causing cranial polyneuropathy and unilateral central retinal vein occlusion]. Rinsho Shinkeigaku 40(9):937–940PubMed
7.
go back to reference Allison DJ, Marano GD (1985) Computed tomography of rheumatoid pachymeningitis. AJNR Am J Neuroradiol 6(6):976–977PubMed Allison DJ, Marano GD (1985) Computed tomography of rheumatoid pachymeningitis. AJNR Am J Neuroradiol 6(6):976–977PubMed
8.
go back to reference Correale J, Ameriso S, Meli F, Rey R, Garcea O, Monteverde D (1988) Chronic pachymeningitis associated with hypereosinophilia. Arq Neuro-Psiquiat 46:406–413 Correale J, Ameriso S, Meli F, Rey R, Garcea O, Monteverde D (1988) Chronic pachymeningitis associated with hypereosinophilia. Arq Neuro-Psiquiat 46:406–413
9.
go back to reference Fujimoto M, Kira J, Murai H, Yoshimura T, Takizawa K, Goto I (1993) Hypertophic cranial pachymeningitis associated with mixed connective tissue disease: a comparison with idiopathic and infectious pachymeningitis. Intern Med 32(6):510–512PubMedCrossRef Fujimoto M, Kira J, Murai H, Yoshimura T, Takizawa K, Goto I (1993) Hypertophic cranial pachymeningitis associated with mixed connective tissue disease: a comparison with idiopathic and infectious pachymeningitis. Intern Med 32(6):510–512PubMedCrossRef
10.
go back to reference Higgins WL, Marano GD (1986) Gallium imaging of rheumatoid pachymeningitis. Clin Nucl Med 11(5):350–351PubMedCrossRef Higgins WL, Marano GD (1986) Gallium imaging of rheumatoid pachymeningitis. Clin Nucl Med 11(5):350–351PubMedCrossRef
11.
go back to reference Horiguchi T, Gotoh K, Yoshida K, Toya S (1996) A successful case of hypertrophic cranial pachymeningitis treated by optic nerve decompression. No Shinkei Geka 24(3):281–285PubMed Horiguchi T, Gotoh K, Yoshida K, Toya S (1996) A successful case of hypertrophic cranial pachymeningitis treated by optic nerve decompression. No Shinkei Geka 24(3):281–285PubMed
12.
go back to reference Masson C, Henin D, Hauw JJ, Rey A, Raverdy P, Masson M (1993) Cranial pachymeningitis of unknown origin: a study of seven cases. Neurology 43(7):1329–1334PubMed Masson C, Henin D, Hauw JJ, Rey A, Raverdy P, Masson M (1993) Cranial pachymeningitis of unknown origin: a study of seven cases. Neurology 43(7):1329–1334PubMed
13.
go back to reference Weinstein GW, Powell SR, Thrush WP (1987) Chiasmal neuropathy secondary to rheumatoid pachymeningitis. Am J Ophthalmol 104(4):439–440PubMed Weinstein GW, Powell SR, Thrush WP (1987) Chiasmal neuropathy secondary to rheumatoid pachymeningitis. Am J Ophthalmol 104(4):439–440PubMed
14.
go back to reference Kajimoto Y, Kihira T, Miwa H, Kondo T (2002) [Hypertrophic pachymeningitis carcinomtosa in a patient with the breast cancer]. No To Shinkei 54(7):626–627PubMed Kajimoto Y, Kihira T, Miwa H, Kondo T (2002) [Hypertrophic pachymeningitis carcinomtosa in a patient with the breast cancer]. No To Shinkei 54(7):626–627PubMed
Metadata
Title
Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis
Author
Jane W. Chan
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 7/2006
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-005-0049-4

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