# Antineutrophilic Cytoplasmic Antibody-Related Spinal Pachymeningitis

## TL;DR

This paper presents a rare case of spinal pachymeningitis caused by antineutrophilic cytoplasmic antibodies, highlighting the diagnostic challenges and offering guidance for similar cases.

## Contribution

The novelty lies in describing a rare case and diagnostic approach for antineutrophilic cytoplasmic antibody-related spinal pachymeningitis.

## Key findings

- Spinal pachymeningitis caused by antineutrophilic cytoplasmic antibodies can present with progressive lower extremity weakness.
- Diagnostic challenges include overlapping clinical features and prior treatments affecting data interpretation.
- A structured diagnostic framework is proposed to aid in evaluating similar cases.

## Abstract

Isolated spinal pachymeningitis is rarely encountered in clinical practice. Narrowing down the specific cause in individual patients is challenging as the possible etiologies are broad, there is substantial overlap in clinical presentation, and obtaining adequate data is complex, often affected by prior empiric treatments, including steroids. Here, we describe a rare patient with spinal pachymeningitis resulting in subacute to chronic progressive lower extremity weakness and eventually paraplegia. We discuss how we obtained the final diagnosis, provide our diagnostic framework, and offer practical advice in evaluating these patients.