Abstract Details

Title Hypertrophic Cervical Spine Pachymeningitis due to Sarcoidosis: A Case Report

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-063

Objective NA

Background Hypertrophic pachymeningitis (HP) is a chronic, progressive diffuse inflammatory condition that leads to thickening of the dura mater and can be idiopathic or associated with sarcoidosis among other disorders. In this case report, we present a rare case of cervical spine HP in a 29-year-old woman in the post-partum period, who had a history of pituitary adenoma and juvenile rheumatoid arthritis.

Design/Methods NA

Results Magnetic resonance imaging (MRI) of the spine revealed a soft tissue mass and moderate cord compression. The patient underwent C3-C7 laminectomy. Pathological analysis of the cervical epidural mass demonstrated a reactive inflammatory cell process. Recurrence of symptoms and worsening of pachymeningitis on imaging studies warranted further work-up which revealed mediastinal/hilar lymphadenopathy. Transbronchial biopsy revealed non-caseating granulomatous disease consistent with sarcoidosis. The patient was started on oral steroids and eventually methotrexate with significant clinical and radiographic improvement. Follow-up imaging studies showed minimal dural thickening in the thoracic spine and eventually complete resolution.

Conclusions Hypertrophic pachymeningitis should be considered in a patient with spinal cord compression, myelopathy, and radicular pain of unclear etiology, and sarcoidosis should be considered in idiopathic cases.

Authors/Disclosures
Dev Mehta, DO (New York-Presbyterian Queens) PRESENTER	Dr. Mehta has nothing to disclose.
	No disclosure on file
Dmitry Khaitov, MD (LVHN)	Dr. Khaitov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
Hussam A. Yacoub, DO (The Lehigh Valley Health Network)	Dr. Yacoub has nothing to disclose.

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