ANCA-associated hypertrophic spinal pachymeningitis presenting with longitudinally extensive transverse myelitis: A case report

The man first visited other hospital; there were no characteristic findings about magnetic resonance image (MRI) of his head, but MRI of spine showed thickening of spinal cord at T8-L2 level. [...]the patient was diagnosed as myelitis, and his symptoms were improved significantly by treating with prednisolone. A gadolinium (Gd)-enhanced MRI scan of spinal cord demonstrated thickening and enhancement of the soft and dura mater, especially at the level of T4 and below [Figure 1]a and [Figure 1]b. The T2-MRI of the spine showed swelling of the spinal cord at the level of T4-T12 and thickening of soft tissue around the spinal canal at the level of T4 and below [Figure 1]c. The electrocardiography and CT scan detected no remarkable findings. [...]HSP is a rare disease, especially when presented with transverse myelitis, making it difficult for clinicians to consider this disease in the first place.