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Neuro-Psiquiatr."],"abstract":"<jats:p>ABSTRACT  Importance: Hypertrophic pachymeningitis (HP) is a non-usual manifestation of rheumatologic, infectious, and neoplastic diseases. Etiological diagnosis is a challenge, but when made promptly it creates a window of opportunity for treatment, with the possibility of a total reversal of symptoms.  Observations: HP is an inflammatory process of the dura mater that can occur as a manifestation of sarcoidosis, granulomatosis with polyangiitis, and IgG4-related disease. The HP case evaluation is extensive and includes central nervous system imaging, cerebrospinal fluid analysis, serology, rheumatologic tests, and systemic survey for other manifestations sites. After systemic investigation, meningeal biopsy might be necessary. Etiology guides HP treatment, and autoimmune disorders are treated with corticosteroids alone or associated with an immunosuppressor.  Conclusion: HP is a manifestation of several diseases, and a precise etiological diagnosis is crucial because of the difference among treatments. An extensive investigation of patients with HP helps early diagnosis and correct treatment.<\/jats:p>","DOI":"10.1590\/0004-282x20200073","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T01:18:49Z","timestamp":1607476729000},"page":"797-804","source":"Crossref","is-referenced-by-count":29,"title":["A clinical approach to hypertrophic pachymeningitis"],"prefix":"10.1590","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-5993","authenticated-orcid":false,"given":"Fabiano Ferreira","family":"Abrantes","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1273-9083","authenticated-orcid":false,"given":"Marianna Pinheiro Moraes de","family":"Moraes","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-5898","authenticated-orcid":false,"given":"Fl\u00e1vio Moura","family":"Rezende Filho","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-8894","authenticated-orcid":false,"given":"Jos\u00e9 Luiz","family":"Pedroso","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-0831","authenticated-orcid":false,"given":"Orlando Graziani Povoas","family":"Barsottini","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020,12]]},"reference":[{"issue":"7","key":"ref1","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1136\/jnnp-2013-306410","article-title":"A nationwide survey of hypertrophic pachymeningitis in Japan","volume":"85","author":"Yonekawa T","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s10072-018-3689-3","article-title":"Clinical features of hypertrophic pachymeningitis in a center survey","volume":"40","author":"Ca\u00e7\u00e3o G","year":"2019","journal-title":"Neurol Sci"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jns.2016.06.024","article-title":"Hypertrophic pachymeningitis","volume":"367","author":"Hahn LD","year":"2016","journal-title":"J Neurol Sci"},{"issue":"30","key":"ref4","article-title":"Characteristics, outcome and treatments with cranial pachymeningitis. 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