[A clinical study of pachymeningitis]

We report five patients with cranial and spinal pachymeningitis not associated infections or tumors. The underlying causes of pachymeningitis in four patients were Sjögren syndrome, Wegener's granulomatosis, microscopic polyangitis, and dermatomyositis, respectively. In one patient, the cause was unknown. Cerebrospinal fluid analysis showed an increase in cells in only one patient and elevated protein levels in three patients. Blood test revealed an inflammatory disease except in one patient. The anti-nuclear antibody was present in four of five patients examined, and P-ANCA was present in two out of four patients. The prognosis was good except in one patient of Wegener's granulomatosis. We reviewed 48 previously reported cases of pachymeningitis were not associated infections or tumors. The lesions of pachymeningitis were more localized in the cranial dura than the spinal dura, and many cases had immunological abnormalities.