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 …