Hypertrophic pachymeningitis: causes

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Hypertrophic pachymeningitis: causes. Sjogren’s syndrome, Wegener’s granulomatosis, Rheumatoid arthritis (RA). Fully referenced neurology checklist.

Autoimmune causes

  • Sjogren’s syndrome
  • Wegener’s granulomatosis
  • Rheumatoid arthritis (RA)
  • IgG4-related hypertrophic pachymeningitis (IgG4-RHP)
  • Anti-neutrophil cytoplasmic antibody (ANCA)
  • Crohn’s disease
  • Relapsing polychondritis

Infectious causes

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Inflammatory causes

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Other causes

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References

  1. Ginsberg L, Kidd D. Chronic and recurrent meningitis. Pract Neurol 2008; 8:348-361.
  2. Kupersmith, MJ, Martin V, Heller G, Shah A, Mitnick HJ. Idiopathic hypertrophic pachymeningitis. Neurology 2004; 62:686-694.
  3. Nayak A, Sharma S, Koshy KG, Thomas B, Kesavadas C. Teaching NeuroImage: Sjögren syndrome presenting with craniospinal hypertrophic pachymeningitis. Neurology 2025; 105:e214382. 
  4. Lee YS, Lee HW, Park KS, Park SH, Hwang JH. Immunoglobulin g4 related hypertrophic pachymeningitis with skull involvement. Brain Tumor Res Treat 2014; 2:87-91.
  5. Lu LX, Della-Torre E, Stone JH, Clark SW. IgG4-related hypertrophic pachymeningitis: clinical features, diagnostic criteria, and treatment. JAMA Neurol 2014; 71:785-793.
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