Hypertrophic pachymeningitis in a patient with antiphospholipid syndrome and chronic hepatitis C virus infection

AbstractHerein, we discuss a case of a 51-year-old female who was presented with a severe headache and high-grade fever. Deep venous thrombosis of the left leg and erythema nodosum had been pointed out two months previously. On admission, laboratory tests showed hepatitis C virus (HCV) infection, prolonged coagulation time and positive anticardiolipin antibody. Lung perfusion scintigraphy revealed multiple peripheral perfusion defects. The serological features and thrombosis strongly suggested the existence of antiphospholipid antibody syndrome (APS). From the findings of the magnetic resonance imaging (MRI) and computed tomography (CT) scan, pachymeningitis was diagnosed. An oral corticosteroid (prednisolone 60 mg/day) was effective for treating the patient’s headache and fever, as well as the thickening of the dura mater. Based on her clinical history, her pachymeningitis was suspected to be associated with APS. Persistent HCV infection might have triggered these autoimmune conditions. We recommend to i...