Vasculitis & polymyalgia rheumatica
Clinical characteristics of hypertrophic cranial pachymeningitis in granulomatosis with polyangiitis: a retrospective single-center study in China
Authors' conclusion
HCP was a severe manifestation of GPA in our study. Independent factors associated with the occurrence of HCP in patients with GPA included PR3-ANCA negativity, conductive or sensorineural hearing loss, and decreased vision or sudden visual loss.
Study context
- Population
- Patients diagnosed with Granulomatosis with Polyangiitis (GPA) admitted to Peking Union Medical College Hospital, China, January 2003 to September 2021
- Participants
- 78 patients
- Exposure
- GPA with hypertrophic cranial pachymeningitis (HCP) vs GPA without HCP
- HCPn = 26
- Without HCPn = 52reference
- Outcome
- Factors independently associated with GPA-related HCP
Methodological detailssingle-centre, binary logistic regression
- Single-centre
- Binary logistic regression
Main finding
As reported in the abstract
Factors independently associated with GPA-related HCP (binary logistic regression)
- PR3-ANCA negativity, OR 10.698
- p = 0.001
- Conductive or sensorineural hearing loss, OR 10.855
- p = 0.005
- Decreased vision or sudden visual loss, OR 8.647
- p = 0.015
Observational data: associations, not effects.
Further findings
Manifestations of HCP
- Headache
- 100%
- Cranial nerve palsy
- 61.5%
HCP vs without HCP: clinical features
- HCP required more time from initial symptoms to diagnosis, with lower ratio of pulmonary and renal involvement and higher ratio of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) positivity, conductive or sensorineural hearing loss, mastoiditis, and decreased vision or sudden visual loss
Treatment in HCP (n=26)
- Methylprednisolone pulse treatment
- 18
- Intrathecal dexamethasone and MTX
- 18
Original publication
Clinical characteristics of hypertrophic cranial pachymeningitis in granulomatosis with polyangiitis: a retrospective single-center study in China. Arthritis Res Ther. Published 2 January 2024. doi:10.
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