Case report uncovers a diagnosis of granulomatosis with polyangiitis in a female with neurological symptoms, highlighting diagnostic challenges.
Background We present a case of a 19-year-old female who presented after 6 months of worsening headaches and unilateral hearing loss. Results Initial work-up demonstrated elevated erythrocyte sedimentation rate and C-reactive protein, and MRI of the brain showed basilar-predominant pachymeningitis. Meningeal biopsy was confirmatory for a diagnosis of granulomatosis with polyangiitis. Conclusions The differential for pachymeningitis is broad, and this case was especially challenging as the patient only presented with isolated neurological symptoms and lacked other organ involvement. The diagnosis for this patient was ultimately dependent on a biopsy of the affected site.
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Wade et al. (2026) studied this question.
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