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Combined therapy of corticosteroid and azathioprine in hypertrophic cranial pachymeningitis

Authors
 Choi I.S.  ;  Park S.C.  ;  Jung Y.K.  ;  Lee S.S. 
Citation
 European Neurology, Vol.44(4) : 193-198, 2000 
Journal Title
 European Neurology 
ISSN
 0014-3022 
Issue Date
2000
MeSH
Adrenal Cortex Hormones/administration & dosage* ; Aged ; Azathioprine/administration & dosage* ; Disease Progression ; Drug Therapy, Combination ; Dura Mater/drug effects ; Dura Mater/pathology* ; Female ; Humans ; Hypertrophy/drug therapy* ; Hypertrophy/pathology ; Hypertrophy/physiopathology ; Magnetic Resonance Imaging ; Male ; Meningitis/drug therapy* ; Meningitis/pathology ; Meningitis/physiopathology ; Middle Aged ; Secondary Prevention ; Treatment Outcome
Keywords
Hypertrophic pachymeningitis ; Dura mater ; Corticosteroid ; Azathioprine
Abstract
Hypertrophic cranial pachymeningitis (HCP) is a rare inflammatory disease of unknown origin in which recurrence is frequently observed in spite of the initial response to steroid therapy. Three patients, 1 man and 2 women, aged 63, 66, and 67 years, with severe intractable headache were evaluated by brain MRI. All patients were initially given prednisolone (60 mg/day, oral) or dexamethasone (20 mg/day, i.v.), and followed by long-term (at least 1 year) azathioprine therapy. All patients were evaluated by follow-up laboratory tests and brain MRI study, and completed the 2-year follow-up period. Symptoms including headache were initially improved with corticosteroid therapy, but patients became steroid-dependent. Azathioprine administration in these steroid-dependent patients permitted the complete cessation of corticosteroid and led to the clinical and radiological recovery. In conclusion, initial high-dose corticosteroid administration followed by long-term azathioprine therapy may be the ideal treatment of HCP at present.
Full Text
https://www.karger.com/Article/FullText/8235
DOI
10.1159/000008235
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Park, Soo Chul(박수철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171632
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