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Rituximab for treatment of pachymeningitis in granulomatosis with polyangiitis
  1. Aditi Patankar,
  2. Sandeep Yadav,
  3. Canchi Balakrishnan and
  4. Sahana Baliga
  1. Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  1. Correspondence to Dr Aditi Patankar; captainaditi{at}


Pachymeningitis is a rare manifestation of granulomatosis with polyangiitis (GPA), and there is a paucity of literature regarding the efficiency of rituximab (RTX) in such cases. We present a woman in her early 50s with GPA who initially responded adequately to conventional therapy. However, the treatment course was complicated by pulmonary cryptococcosis. The patient later developed non-infectious pachymeningitis, which failed to respond to steroids and methotrexate. However, using RTX upfront led to good clinical response and radiological resolution.

  • Cryptococcosis
  • Vasculitis
  • Biological agents

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  • Contributors PA, YS, BC and BS were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content.

    PA, YS and BC gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.