Case Reports
Granulomatosis with polyangiitis: recurrence presenting as ependimoplexitis
C.N. Pisoni, S. Ibañez, M. Guevara, D. Castro, S. Romero Vidomlansky
CER6866
2014 Vol.32, N°3 ,Suppl.82
PI 0070, PF 0072
Case Reports
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PMID: 24642347 [PubMed]
Received: 14/08/2013
Accepted : 20/11/2013
In Press: 17/03/2014
Published: 16/05/2014
Abstract
A 55-year-old man with granulomatosis with polyangiitis (GPA) developed continuous parietal headache, malaise, nasal crusting and dry cough. Neurological exam revealed only left hand hypoesthesia in 4th and 5th finger. Brain MRI showed enlarged right choroid plexus, hyperintense periventricular white matter, thalami and right side of corpus callosum. The suspected diagnosis was ependimoplexitis due to GPA, the patient received three 500 mg methylprednisolone pulses followed by 1 mg/kg of meprednisone with gradual tapering and was switched to oral cyclophosphamide. He had complete resolution of headache. An MRI following this treatment for relapse revealed only minimal ependimal changes.