A case of acute onset headache and visual loss

Deepa Ragesh Panikkath MD

ABSTRACT

Granulomatosis with polyangiitis (GPA) is a multisystem autoimmune disorder. Typically, GPA presents with upper airway, pulmonary, and renal symptoms; an initial presentation limited to central system involvement (CNS) is rare. This case report describes a 54-year-old woman who presented with persistent daily headaches and a visual defect. Investigation revealed meningeal inflammation and optic neuritis demonstrated by magnetic resonance imaging and positive serine proteinase-3 ANCA serology diagnostic of GPA. She had a dramatic clinical response to corticosteroids. This case highlights a rare initial presentation of GPA with CNS manifestations.

Keywords: Granulomatosis with polyangiitis (GPA), pachymeningitis, anti-PR3 cANCA

Article citation: Panikkath DR. A case of acute onset headache and visual loss. The Southwest Respiratory and Critical Care Chronicles 2019;7(27):55–57
From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas
Submitted: 9/28/2018
Accepted: 12/10/2018
Reviewers: James Tarbox MD, John Pixley MD
Conflicts of interest: none
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