Case Report

Meningeal Involvement in Wegener's Granulomatosis

ALI AL DHANHANI, ROBERT MacAULAY, BILL MALONEY, and JOHN G. HANLY

ABSTRACT.

We describe a patient with Wegener's granulomatosis (WG) who developed neurological symptoms attributed to meningeal involvement. The diagnosis of WG was complicated by persistently negative antineutrophil cytoplasmic antibodies (ANCA) and lack of specificity in the histopathological findings from multiple anatomical sites. This rare neurological manifestation of WG was treated successfully with oral cyclophosphamide and the patient has continued remission for 3 years taking oral methotrexate. (J Rheumatol 2006;33:364-7)

Key Indexing Terms:

WEGENER'S GRANULOMATOSIS
MENINGEAL INVOLVEMENT
NERVOUS SYSTEM

---

From the Division of Rheumatology, Department of Medicine, the Division of Anatomical Pathology, Department of Pathology, and the Department of Diagnostic Imaging, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.

A. Al Dhanhani, MD, Resident in Internal Medicine; R. MacAulay, MD, FRCPC, Professor of Pathology; B. Maloney, MD, FRCPC, Assistant Professor of Radiology; J.G. Hanly, MD, MRCPI, FRCPC, Professor of Medicine.

Address reprint requests to Dr. J.G. Hanly, Division of Rheumatology, Nova Scotia Rehabilitation Center, 1241 Summer Street, Halifax, Nova Scotia B3H 4K4. E-mail: john.hanly@cdha.nshealth.ca

Accepted for publication September 26, 2005.

---