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NEUROLOGY 1997;48:263-265
© 1997 American Academy of Neurology

Meningeal Involvement in Wegener's Granulomatosis Confirmed and Monitored by Positive Circulating Antineutrophil Cytoplasm in Cerebrospinal Fluid

M. Spranger, MD, S. Schwab, MD, H.-M. Meinck, MD, M. Tischendorf, MD, J. Sis, A. Breitbart, MD and K. Andrassy, MD

From the Departments of Neurology (Drs. Spranger, Schwab, and Meinck), Neuroradiology (Dr. Tischendorf), and Internal Medicine (J. Sis and Drs. Breitbart, and Andrassy), University of Heidelberg, Germany.
Received May 17, 1996. Accepted in final form July 5, 1996.
Address correspondence and reprint requests to Dr. Matthias Spranger, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.

MRI and CSF investigations revealed meningeal involvement in a 29-year-old patient with biopsy-confirmed Wegener's granulomatosis. The intracranial manifestation of Wegener's granulomatosis was supported by the detection of pathologic circulating antineutrophil cytoplasm (c-ANCA) in the CSF. We monitored disease activity by c-ANCA measurement in the CSF. After repeated cycles of intrathecal administration of methotrexate and corticoids, progression of meningeal infiltration stopped, and CSF c-ANCA titers became negative.

NEUROLOGY 1997;48: 263-265




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