Case Report

A case of granuloma in the occipital lobe of a patient with Wegener’s granulomatosis

Authors

Naoto Azuma^1,2, Yoshinori Katada², Nobumasa Nishimura³, Tomonori Yamada³, Ryunosuke Uranishi³, Shinichi Nakatsuka⁴, Makoto Dehara⁵, Yoshinori Harada², Takao Yamanaka² and Yukihiko Saeki⁶

1. Division of Rheumatology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
2. Division of Allergy and Clinical Immunology, National Hospital Organization Osaka-Minami Medical Center, 2-1 Kido-Higashi-machi, Kawachinagano, Osaka 586-8521, Japan
3. Division of Neurosurgery, National Hospital Organization Osaka-Minami Medical Center, Kawachinagano, Osaka, Japan
4. Department of Pathology, National Hospital Organization Osaka-Minami Medical Center, Kawachinagano, Osaka, Japan
5. Division of Neurosurgery, Rinku General Medical Center, Izumisano, Osaka, Japan
6. Department of Clinical Investigation, National Hospital Organization Osaka-Minami Medical Center, Kawachinagano, Osaka, Japan

Received:

28 November 2007

Accepted:

10 March 2008

Published online:

19 April 2008

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Abstract

We report a case of Wegener’s granulomatosis (WG) with central nervous system (CNS) involvement in a woman who complained of bilateral visual disturbance. The intracranial necrotizing granulomatous lesion was confirmed by MR imaging and brain biopsy. After high-dose oral corticosteroid treatment, not only clinical manifestations but also laboratory tests improved. Moreover, the CNS lesion completely regressed. This suggests that high-dose corticosteroid alone might be effective in treating WG with CNS involvement.

Key words

Central nervous system involvement - High-dose corticosteroid therapy - Intracranial granuloma - MR imaging - Wegener’s granulomatosis