{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:42:26Z","timestamp":1767192146706,"version":"3.48.0"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and clinical significance: Idiopathic hypertrophic pachymeningitis (IHPM) is a rare inflammatory disorder characterized by diffuse or focal dural thickening and heterogeneous presentations. We report a corticosteroid-responsive IHPM with elevated anti-thyroglobulin (anti-Tg) antibodies despite oncologic control after thyroidectomy. This case suggests that systematic assessment for autoimmunity should be a standard component of the IHPM work-up. Case presentation: A 77-year-old woman presented with recurrent vertigo, imbalance, and headaches. Brain MRI showed diffuse pachymeningeal thickening with mild heterogeneous enhancement, radiologically stable over &gt;2 years. Extensive evaluation excluded infectious, neoplastic (including paraneoplastic), cerebrospinal fluid hypotension and systemic autoimmune causes; findings did not support IgG4-related disease. Thyroid work-up revealed hypothyroidism with multinodular goiter; total thyroidectomy was performed, and there was no indication for adjuvant radioiodine therapy. Despite oncologic control, anti-Tg antibodies remained markedly elevated, while anti-thyroid peroxidase antibodies (anti-TPO) declined. Symptoms repeatedly improved with oral methylprednisolone and recurred on taper; adverse effects were mild and manageable. The patient remains under clinical and oncologic surveillance with symptom-guided steroid re-challenge. Conclusions: IHPM may exhibit a dissociation between clinical response and radiologic course. Persistently elevated anti-Tg after thyroidectomy can coexist with IHPM and may signal ongoing autoimmunity rather than active cancer.<\/jats:p>","DOI":"10.3390\/reports9010015","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:08:11Z","timestamp":1767190091000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Idiopathic Hypertrophic Pachymeningitis with Elevated Anti-Thyroglobulin Antibodies\u2014A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2722-9790","authenticated-orcid":false,"given":"Pawe\u0142","family":"Pobudejski","sequence":"first","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14 Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3693-9565","authenticated-orcid":false,"given":"Mateusz","family":"To\u015b","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14 Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3899-1260","authenticated-orcid":false,"given":"Katarzyna","family":"Zawi\u015blak-Fornagiel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14 Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-660X","authenticated-orcid":false,"given":"Joanna","family":"Siuda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14 Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s00296-007-0504-5","article-title":"Idiopathic Hypertrophic Cranial Pachymeningitis Treated by Oral Methotrexate: A Case Report and Review of Literature","volume":"28","author":"Bosman","year":"2008","journal-title":"Rheumatol. 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