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Kimura Y, Asako K, Kikuchi H, et al. Refractory optic perineuritis due to granulomatosis with polyangiitis successfully treated with methotrexate and mycophenolate mofetil combination therapy. Eur J Rheumatol. 2017;4(1):70-72doi: 10.5152/eurjrheum.2016.028.
Kimura, Y., Asako, K., Kikuchi, H., & Kono, H. (2017). Refractory optic perineuritis due to granulomatosis with polyangiitis successfully treated with methotrexate and mycophenolate mofetil combination therapy. European journal of rheumatology, 4(1), 70-72. https://doi.org/10.5152/eurjrheum.2016.028
Kimura, Yoshitaka, et al. "Refractory optic perineuritis due to granulomatosis with polyangiitis successfully treated with methotrexate and mycophenolate mofetil combination therapy." European journal of rheumatology vol. 4,1 (2017): 70-72. doi: https://doi.org/10.5152/eurjrheum.2016.028
Kimura Y, Asako K, Kikuchi H, Kono H. Refractory optic perineuritis due to granulomatosis with polyangiitis successfully treated with methotrexate and mycophenolate mofetil combination therapy. Eur J Rheumatol. 2017 Mar;4(1):70-72. doi: 10.5152/eurjrheum.2016.028. Epub 2017 Mar 01. PMID: 28293459; PMCID: PMC5335893.
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Eur J Rheumatol. 2017 Mar;4(1):70-72. doi: 10.5152/eurjrheum.2016.028. Epub 2017 Mar 01.

Refractory optic perineuritis due to granulomatosis with polyangiitis successfully treated with methotrexate and mycophenolate mofetil combination therapy.

European journal of rheumatology

Yoshitaka Kimura, Kurumi Asako, Hirotoshi Kikuchi, Hajime Kono

Affiliations

  1. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan; Department of Allergy and Rheumatology, Tokyo University Graduate School of Medicine, Tokyo, Japan.
  2. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.

PMID: 28293459 PMCID: PMC5335893 DOI: 10.5152/eurjrheum.2016.028

Abstract

Optic perineuritis is an uncommon inflammatory disorder of the optic sheath that causes visual loss or eye pain. There are few case reports of optic perineuritis associated with granulomatosis with polyangiitis. Herein we report the case of a 37-year-old male with granulomatosis with polyangiitis and who presented with headache, blurred vision in the right eye, diplopia, and numbness in the right forehead. Brain magnetic resonance images (MRI) findings revealed hypertrophic pachymeningitis and refractory optic perineuritis. These were manageable only by means of weekly methotrexate and mycophenolate mofetil combination therapy but not with methotrexate, mycophenolate mofetil, intravenous cyclophosphamide, rituximab, azathioprine, or cyclosporine individually.

Keywords: Granulomatosis with polyangiitis; hypertrophic pachymeningitis; methotrexate; mycophenolate mofetil; optic perineuritis

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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