[Optic neuropathy in a case of recurrent idiopathic hypertrophic pachymeningitis unresponsive to steroids and immunosuppressants]

Arch Soc Esp Oftalmol. 2015 Feb;90(2):97-101. doi: 10.1016/j.oftal.2014.09.004. Epub 2014 Nov 20.
[Article in Spanish]

Abstract

Case report: A 38-year-old female patient with bilateral papilledema who presented with loss of vision in her left eye. The Magnetic Resonance Imagining (MRI) showed thickening of the dura mater, and the intracranial pressure was elevated. A cancer, infectious, and autoimmune origin was ruled out.

Discussion: The initial response to high doses of corticoids was satisfactory, with disappearance of the optic disc enema, with visual acuity and an improvement in the MRI. However, after one year without treatment she had a new outbreak of the disease. Despite renewed treatment with corticoids and azathioprine, the patient developed a left optic neuropathy and irreversible visual loss.

Keywords: Atrofia óptica; Corticoides; Idiopathic hypertrophic pachymeningitis; Immunosuppressants; Inmunosupresores; Neuropatía óptica; Optic atrophy; Optic neuropathy; Paquimeningitis hipertrófica idiopática; Steroids.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Female
  • Humans
  • Hypertrophy
  • Immunosuppressive Agents / therapeutic use
  • Meningitis / complications*
  • Meningitis / pathology
  • Optic Nerve Diseases / drug therapy
  • Optic Nerve Diseases / etiology*
  • Recurrence
  • Treatment Failure

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents