Correct!
5. All of the above
Idiopathic hypertrophic pachymeningitis is an uncommon disorder that causes a localized or diffuse thickening of the dura mater (1). The disease can produce a spectrum of neurologic symptoms depending on the anatomic location of the affected dura. It can be idiopathic but has been associated with rheumatoid arthritis, syphilis, Wegener’s granulomatosis, tuberculosis, and cancer.
The negative ANCA and the normal serum ACE make GPA and sarcoidosis less likely but neither excludes these diagnoses.
What should be done next in her diagnostic work up?