Vasculitis & polymyalgia rheumatica
Distinct features of ANCA-associated hypertrophic pachymeningitis compared with other etiologies: findings from a study of 74 patients
Authors' conclusion
Within our cohort, GPA and Mycobacterium tuberculosis emerged as the predominant causes of HP. We identified significant disparities in clinical and radiological features among the various etiologies
Study context
- Population
- Patients diagnosed with hypertrophic pachymeningitis (dural thickening on brain or spine MRI), 2003–2022, single tertiary referral centre
- Participants
- 32 / 45 / 21 / 21
- Exposure
- Immune-mediated vs infectious vs malignancy-associated hypertrophic pachymeningitis (HP)
- Immune-mediated HPn = 32
- Non-immune-mediated HPn = 45
- Infectious HPn = 21
- Malignancy-associated HPn = 21
- Outcome
- Clinical and radiological features, and outcomes, of HP by etiology
Methodological detailssingle-centre, tertiary referral centre
- Single-centre
- Tertiary referral centre
Main finding
As reported in the abstract
Etiology of HP
- Granulomatosis with polyangiitis (GPA) (predominantly PR3-ANCA positive) among immune-mediated HP
- 21
- TB-HP among infectious HP
- 14
Observational data: associations, not effects.
Further findings
Distinguishing features by etiology
- Hypoglycorrhachia mainly in infectious and malignancy-associated HP
- Immune-mediated HP associated with peripheral contrast enhancement and the Eiffel-by-night sign
- TB-HP strongly indicated by leptomeningeal involvement, brain parenchymal lesions and arterial stroke
- MPO-ANCA GPA associated with higher prevalence of spinal HP
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Distinct features of ANCA-associated hypertrophic pachymeningitis compared with other etiologies: findings from a study of 74 patients. Rheumatology (Oxford). Published 17 May 2024. doi:10.
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