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Intrathecal injection of methotrexate and dexamethasone for vasculitis granuloma of the fourth ventricle: a case report and literature review

Clinical Rheumatology, ISSN: 1434-9949, Vol: 43, Issue: 3, Page: 1217-1226
2024
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  • 3
    Captures
  • 1
    Mentions
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  • Captures
    3
  • Mentions
    1
    • News Mentions
      1
      • 1

Most Recent News

Recent Findings in Granuloma Described by Researchers from Zunyi Medical University (Intrathecal Injection of Methotrexate and Dexamethasone for Vasculitis Granuloma of the Fourth Ventricle: a Case Report and Literature Review)

2023 NOV 01 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Cardiovascular Daily -- Investigators publish new report on Lymphoproliferative Diseases and Conditions

Review Description

Granulomatosis with polyangiitis (GPA) is a pauci-immune small vessel vasculitis characterised by neutrophil-mediated vasculitis and granuloma. The presence of intracranial parenchymal space-occupying lesions is rarely seen in GPA patients. In this manuscript, we report a case of GPA with granuloma of the fourth ventricle accompanied by obstructive hydrocephalus. Treatment with glucocorticoids (GCs) and multiple immunosuppressants cyclophosphamide (CYC), mycophenolate mofetil (MMF), and rituximab (RTX) showed poor efficacy in this case. After removal of the granuloma by craniotomy, GPA relapsed within 3 months. Under the premise of GC and MMF treatment combined with intrathecal injection of dexamethasone (DXM) and methotrexate (MTX), the intracranial granuloma gradually shrank, and the patient’s general condition was alleviated, showing that this is an effective treatment method. (Table presented.)

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