Rheumatoid factor positive hypertrophic cranial pachymeningitis in association with hypopituitarism and multiple cranial nerve palsies.

Y. Manabe, H. Narai, H. Warita, T. Hayashi, K. Sakai, Koji Abe

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

This is the first report of a patient presenting with rheumatoid factor (RF) positive hypertrophic cranial pachymeningitis (HCP) in association with hypopituitarism and multiple cranial nerve palsies. Our patient developed palsies of the left II and III, bilateral VI and VII, and right IX, X, and XII cranial nerves. A stimulation test showed hypopituitarism due to hypothalamic failure. The patient was seropositive for RF but had no multiple joint pain or deformities. Magnetic resonance imaging (MRI) showed thickened dura of the sellar and parasellar region, hypothalamus, bilateral cavernous sinuses and the tentorium all of which were enhanced by gadolinium (Gd). Treatment with prednisone improved clinical symptoms and MRI findings concomitant with reduction of RF titer. Although the exact mechanism of HCP has not been clearly elucidated, the present case suggests an autoimmune mechanism associated with RF.

Original languageEnglish
Pages (from-to)964-967
Number of pages4
JournalInternal Medicine
Volume40
Issue number9
Publication statusPublished - Sep 2001

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Cranial Nerve Diseases
Hypopituitarism
Rheumatoid Factor
Meningitis
Magnetic Resonance Imaging
Glossopharyngeal Nerve
Hypoglossal Nerve
Cavernous Sinus
Vagus Nerve
Gadolinium
Arthralgia
Prednisone
Paralysis
Hypothalamus
Therapeutics

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Rheumatoid factor positive hypertrophic cranial pachymeningitis in association with hypopituitarism and multiple cranial nerve palsies. / Manabe, Y.; Narai, H.; Warita, H.; Hayashi, T.; Sakai, K.; Abe, Koji.

In: Internal Medicine, Vol. 40, No. 9, 09.2001, p. 964-967.

Research output: Contribution to journalArticle

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