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2015 ; 2015
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Rheumatoid meningitis: a rare complication of rheumatoid arthritis
#MMPMID26135486
Lu L
; Chwalisz B
; Pfannl R
; Narayanaswami P
BMJ Case Rep
2015[Jul]; 2015
(ä): ä PMID26135486
show ga
We present a case of a 60-year-old Caucasian woman with a 23-year history of
rheumatoid arthritis, who presented with a 2-week history of headache and
cognitive/behavioural changes. On the basis of clinical features, radiology,
laboratory data and meningeal biopsy, a diagnosis of rheumatoid meningitis was
performed. High-dose intravenous methylprednisolone was used as initial treatment
followed by oral prednisone. The patient's symptoms improved and repeat MRI scans
confirmed resolution of the meningeal lesions. The clinical diagnosis of
rheumatoid meningitis is difficult, but it must be considered in patients with
long-standing rheumatoid arthritis presenting with neurological symptoms.
Glucocorticoids or other immunomodulatory therapy are the mainstay of treatment.