Idiopathic Hypertrophic Cranial Pachymeningitis with Scleritis and Optic Disc Involvement: a Case Report and Literature Review

This report describes a case of idiopathic hypertrophic cranial pachymeningitis (IHCP) with scleritis and optic disc involvement. The patient was a 56-year-old woman with chief complaints of fever, headache, binocular pain, and redness. Biochemical and immunological indicators, cranial magnetic reso...

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Bibliographic Details
Published in:Ocular immunology and inflammation 2024-08, Vol.ahead-of-print (ahead-of-print), p.1-6
Main Authors: Cai, Xuecheng, Hong, Nan, Li, Huiyan, Jiang, Bo, Fang, Jianxia, Shao, Jiechao, Liang, Hui, Shen, Ye
Format: Article
Language:English
Subjects:
Diagnosis, Differential
Female
Glucocorticoids - therapeutic use
Humans
Hypertrophy - diagnosis
Idiopathic hypertrophic cranial pachymeningitis
Magnetic Resonance Imaging
Meningitis - complications
Meningitis - diagnosis
Middle Aged
optic disc involvement
Optic Disk - pathology
scleritis
Scleritis - diagnosis
Scleritis - drug therapy
Tomography, Optical Coherence
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Summary:This report describes a case of idiopathic hypertrophic cranial pachymeningitis (IHCP) with scleritis and optic disc involvement. The patient was a 56-year-old woman with chief complaints of fever, headache, binocular pain, and redness. Biochemical and immunological indicators, cranial magnetic resonance imaging, and relevant ophthalmological examinations were employed for evaluation. Infectious and neoplastic causes were excluded. Typical meningeal thickening and enhancement on magnetic resonance imaging revealed IHCP. Diffuse hyperaemia and oedema of the conjunctiva and the T-shape sign on the B-scan suggested anterior and posterior scleritis, respectively. Abnormalities in fundus photography, optical coherence tomography, and visual field examination suggested optic disc involvement. After anti-infection and steroid therapy, the patient's temperature returned to normal and the symptoms of headache, binocular pain, and redness improved. Neurologists and ophthalmologists should consider the combination of IHCP with scleritis in their differential diagnosis when patients complain of headache accompanied by ocular pain and redness.
ISSN:0927-3948
1744-5078
1744-5078
DOI:10.1080/09273948.2023.2183221