PT - JOURNAL ARTICLE AU - A Gigante AU - K Giannakakis AU - M Visentini AU - M Fiorilli AU - B Barbano AU - R Renzulli AU - F Borghesi AU - R Cianci TI - A simultaneous occurrence of Tolosa–Hunt syndrome and fibrillary glomerulonephritis: a case report AID - 10.1136/jcp.2008.061648 DP - 2009 Feb 01 TA - Journal of Clinical Pathology PG - 190--191 VI - 62 IP - 2 4099 - http://jcp.bmj.com/content/62/2/190.short 4100 - http://jcp.bmj.com/content/62/2/190.full SO - J Clin Pathol2009 Feb 01; 62 AB - Fibrillary glomerulonephritis (FibGN) is a rare cause of progressive renal dysfunction, often leading to dialysis within a few years. A 60-year-old woman presented with a 2 month history of right-sided retro-orbital pain and recent diplopia. Laboratory testing revealed an altered renal function with increased serum creatinine and mild proteinuria. MRI of the brain revealed the presence of a soft tissue mass on the right cavernous sinus compatible with the diagnosis of Tolosa–Hunt syndrome (THS). Renal biopsy showed a pattern compatible with fibrillary glomerulonephritis. For this reason steroid therapy was initiated at a dose of 1 mg/kg/day and adjusted according to the clinical course. Neurological symptoms regressed shortly after the beginning of therapy and renal function and proteinuria remained stable for the 3 years following the withdrawal of steroid therapy. Percutaneous renal biopsy was again performed and confirmed the previous diagnosis of FibGN in association with other glomerular-lesion-like mesangial widening, thickening of capillary walls and severe arterio-arteriolosclerosis. This case report describes what is believed to first report of the association of FibGN and THS, which both responded to steroid therapy.