Document Type

Article

Publication Date

12-19-2018

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in Journal of Neuroimmunology, Volume 328, December 2018, Pages 73-75.

The published version is available at https://doi.org/10.1016/j.jneuroim.2018.12.001. Copyright © Lee-Ching et al.

Abstract

Rheumatoid meningitis is a rare and very serious extra-articular manifestation of rheumatoid arthritis. We present a case of a 7()year-old female with no history of arthritis who developed stroke-like symptoms, seizures, psychosis and compulsive behavior. Serial brain magnetic resonance images (MRI) over four months demonstrated progressive interhemispheric meningeal thickening. She had mild lymphocytic pleocytosis on the cerebrospinal fluid analysis and serum anti-cyclic citrullinated peptide antibodies resulted positive in high titers. She underwent a brain biopsy showing necrotizing granulomas consistent with rheumatoid meningitis. Her symptoms resolved with treatment with glucocorticoids and cyclophosphamide. She has not been diagnosed with rheumatoid arthritis even after 1 year of follow up. Clinicians should be aware of the possibility of rheumatoid meningitis without rheumatoid arthritis and keep it on the differential for patients with aseptic meningitis and otherwise negative work up.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Highlights.docx (13 kB)

PubMed ID

30597393

Language

English

Available for download on Thursday, December 19, 2019

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