Granulomatosis with polyangiitis presenting with pachimeningitis and persistent headache

  • Maria Sofia Cotelli | cotellim@gmail.com Neurology Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Mirko Scarsi Internal Medicine Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Marta Bianchi Neurology Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Valeria Bertasi Neurology Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Patrizia Civelli Neurology Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Filippo Manelli Emergency Unit, ASST Valcamonica Esine, Brescia, Italy.
  • Marinella Turla Neurology Unit, ASST Valcamonica Esine, Brescia, Italy.

Abstract

Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis (WG), is a systemic inflammatory disease, primarily involving the upper and lower respiratory tract and kidneys. It is a relatively uncommon condition, characterized by necrotizing granulomatous vasculitis of smalland medium-sized vessels and the presence of anti-neutrophil cytoplasmic antibodies (ANCA) in the serum as defined in the Chapel Hill Consensus Conference 2012. GPA presents a wide spectrum of manifestations and remains one of the most challenging diagnostic dilemmas in clinical medicine. From common respiratory and neurological symptoms to infrequent cardiac complications, this fatal systemic illness is difficult to distinguish from infectious etiologies, and is often mistaken for an isolated complaint. We report a case of granulomatosis with polyangiitis in a patient with persistent frontal headache, for a very long time considered as migraine versus tension-type headache.

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Published
2020-01-03
Section
Early Release
Keywords:
Granulomatosis, headache, vasculitis, pachimeningitis.
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How to Cite
Cotelli, M. S., Scarsi, M., Bianchi, M., Bertasi, V., Civelli, P., Manelli, F., & Turla, M. (2020). Granulomatosis with polyangiitis presenting with pachimeningitis and persistent headache. Italian Journal of Medicine. https://doi.org/10.4081/itjm.2020.1193