Evidence map›Paper›PMID 37914837›Full record

ReviewClinical rheumatology2024

Intrathecal injection of methotrexate and dexamethasone for vasculitis granuloma of the fourth ventricle: a case report and literature review.

Chunyan Li, Yu Wang, Yupei Lin, Qianla Gong, Bangcui Wu, Wendan Zheng, Yingying Tian, Yong Chen, Mei Tian

Abstract readCase ReportsReview
PubMed Publisher
In one paragraph

Review in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Chunyan LiDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0000-0003-0510-782X
Yu WangDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0000-0001-5025-041X
Yupei LinDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0009-0007-1471-4150
Qianla GongDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0009-0006-1531-643X
Bangcui WuDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0000-0003-3746-6958
Wendan ZhengDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0009-0003-7287-898X
Yingying TianDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0009-0002-8062-9652
Yong ChenDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.ORCID http://orcid.org/0000-0001-5538-5081
Mei TianDepartment of Rheumatology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China. 348820517@qq.com.ORCID http://orcid.org/0000-0002-1633-2988
Zunyi Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Granulomatosis with polyangiitis (GPA) is a pauci-immune small vessel vasculitis characterised by neutrophil-mediated vasculitis and granuloma. The presence of intracranial parenchymal space-occupying lesions is rarely seen in GPA patients. In this manuscript, we report a case of GPA with granuloma of the fourth ventricle accompanied by obstructive hydrocephalus. Treatment with glucocorticoids (GCs) and multiple immunosuppressants cyclophosphamide (CYC), mycophenolate mofetil (MMF), and rituximab (RTX) showed poor efficacy in this case. After removal of the granuloma by craniotomy, GPA relapsed within 3 months. Under the premise of GC and MMF treatment combined with intrathecal injection of dexamethasone (DXM) and methotrexate (MTX), the intracranial granuloma gradually shrank, and the patient's general condition was alleviated, showing that this is an effective treatment method. Key Points • To date, there are few reports of granulomatous vasculitis combined with granuloma of the fourth ventricle, and our case is the second. • In this case, multiple immunosuppressants and rituximab were ineffective treatments, and the intracranial granuloma was effectively controlled by intrathecal injection of dexamethasone (DXM) and methotrexate (MTX). • Based on this report, it can be suggested that intrathecal injection is effective in treating patients with GPA and central nervous system involvement, but large-scale sample studies are needed.

Indexed as

Anti-Neutrophil Cytoplasmic Antibody-Associated VasculitisGranulomatosis with PolyangiitisDexamethasoneFourth VentricleGranulomaHumansImmunosuppressive AgentsInjections, SpinalMethotrexateMycophenolic AcidRituximabDexamethasoneImmunosuppressive AgentsMethotrexateMycophenolic AcidRituximabGranulomatosis with polyangiitis; Granuloma of the fourth ventricleIntrathecal injectionMethotrexate

Identifiers

PMID37914837
OpenAlexW4388230898

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.