Spinal Cord Involvement in Granulomatosis With Polyangiitis: An Unusual Presentation

Abstract

A 40-year-old lady presented with rhinosinusitis, left-sided nodular scleritis and dyspnoea on exertion of 4-month duration. Computed tomography (CT) of the chest showed a cavitary granuloma whose biopsy revealed necrotising vasculitis. Indirect immunofluorescence assay showed anti-neutrophil cytoplasmic antibodies with a cytoplasmic pattern. She was diagnosed as a case of granulomatosis with polyangiitis (GPA) with otorhinological, ocular and pulmonary involvement. A month later, she developed dorsolumbar pain and lower limb parasthesias. Evaluation for the same revealed MRI evidence of granulation tissue at the lower dorsal levels. She was initially managed with injection of cyclophosphamide (CYC) and high-dose steroids, but with an inadequate response. Her treatment protocol was then modified to pulse injection of rituximab (RTX), and she gradually attained an adequate clinical and radiological recovery.




Clin Infect Immun. 2018;3(3-4):80-82
doi: https://doi.org/10.14740/cii66w