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Successful treatment of meningeal involvement in Wegener’s granulomatosis with infliximab
  1. J Hermann1,
  2. P Reittner2,
  3. M Scarpatetti3,
  4. W Graninger1
  1. 1Division of Rheumatology, Department of Internal Medicine, Medical University of Graz, Austria
  2. 2Institute of Radiology, Medical University of Graz, Austria
  3. 3Institute of Pathology, Medical University of Graz, Austria
  1. Correspondence to:
    Dr J Hermann
    Department of Internal Medicine, Division of Rheumatology, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria; josef.hermann{at}meduni-graz.at

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Meningeal involvement in Wegener’s granulomatosis (WG) is rare and only 32 cases have been reported by Reinhold-Keller and coworkers.1,2 The outcome of the disease has improved with the institution of cytotoxic agents.3 We report on a patient with WG and progressive pachymeningeosis despite treatment with cyclophosphamide (CyC) and glucocorticoids who responded well to infliximab treatment.

In December 2003 a 34 year old male chemist was diagnosed with localised WG, according to the American College of Rheumatology criteria and the Capel Hill Conference criteria, on the basis of granulomatous nasal inflammation, left-sided otitis media, and the detection of proteinase-3-antineutrophilic cytoplasmic antibodies (PR3-ANCA) >100 U/ml (normal <5 U/ml).4,5 Because …

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