334 results match your criteria rheumatoid meningitis

Secondary Normal-Pressure Hydrocephalus in Rheumatoid Meningitis.

Case Rep Neurol 2021 May-Aug;13(2):434-440. Epub 2021 Jul 5.

Department of Neurology, Geisinger Medical Center, Danville, Pennsylvania, USA.

Normal-pressure hydrocephalus (NPH) is a common cause of gait apraxia, cognitive impairment, and urinary incontinence in the elderly. It is usually a primary idiopathic disorder but can be secondary. We present a case of secondary NPH due to biopsy-confirmed rheumatoid meningitis initially refractory to intravenous (IV) immunotherapy. Read More

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Characteristics of pulmonary cryptococcosis in patients with rheumatoid arthritis.

BMJ Open Respir Res 2021 Jul;8(1)

Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.

Background And Objective: A high frequency of infections complicating rheumatoid arthritis (RA) has been reported due to the immunomodulatory effect of RA or to agents with immunosuppressive effects used in its treatment. We aimed to assess clinical and radiological characteristics of pulmonary cryptococcosis in patients with and without RA.

Methods: We retrospectively reviewed the medical records of 52 patients with pulmonary cryptococcosis and divided them into two groups, those with RA and without RA, and compared clinical characteristics and radiological findings between them. Read More

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A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related.

Turk J Pediatr 2021 ;63(3):522-526

Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: The adverse effects of tumor necrosis factor alpha inhibitors (TNFi) are well characterized but rare adverse events are increasing day by day.

Case: We presented an 18-year-old girl with rheumatoid factor positive polyarticular juvenile idiopathic arthritis (JIA) who developed fever, headache, and nausea after the second dose of adalimumab. In addition to her suspicious complaints for meningitis, she had bilateral papilledema and partial abducens nerve palsy. Read More

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January 2021

Aseptic Meningitis-retention Syndrome Associated with Tocilizumab in a Patient with Idiopathic Multicentric Castleman Disease.

Intern Med 2021 Jul 3. Epub 2021 Jul 3.

Department of Neurology, NTT Medical Center Tokyo, Japan.

This is the first report of tocilizumab-associated meningitis-retention syndrome in a patient with idiopathic multicentric Castleman disease. A 57-year-old man presented with headache, nuchal rigidity, impaired consciousness, pyramidal tract signs and urinary retention. A cerebrospinal fluid examination revealed increased cell counts and protein levels. Read More

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Enterovirus A71 causing meningoencephalitis and acute flaccid myelitis in a patient receiving rituximab.

J Neuroimmunol 2021 Sep 24;358:577639. Epub 2021 Jun 24.

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America. Electronic address:

We present the case of a young woman being treated with rituximab for rheumatoid arthritis who developed a severe enteroviral meningoencephalitis and acute flaccid myelitis (AFM). Cerebrospinal fluid (CSF) and stool reverse transcription-polymerase chain reaction (RT-PCR) testing confirmed the diagnosis and additional sequencing studies performed at the CDC further characterized the enterovirus as enterovirus A71 (EV-A71). After treatment with intravenous immunoglobulin (IVIg) and fluoxetine (based on previous reports of possible efficacy) the patient experienced a remarkable improvement over time. Read More

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September 2021

[Rheumatoid Meningitis].

Brain Nerve 2021 May;73(5):537-543

Department of Neurology, Yamaguchi Prefectural Medical Center.

Rheumatoid meningitis, a central nervous system complication of rheumatoid arthritis, has low morbidity but poor prognosis without treatment. Contrast-enhanced meningeal lesions on one side of the brain on MRI and hyperintensity of the pia mater on FLAIR image are characteristic features and should trigger the suspicion of rheumatoid meningitis. Steroids are effective for treatment, and good outcomes can be obtained through early diagnosis and intervention. Read More

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Efficacy of Rituximab on Rheumatoid Leptomeningitis as the First Symptom of Rheumatoid Arthritis.

Eur J Case Rep Intern Med 2021 21;8(4):002358. Epub 2021 Apr 21.

Service de Rhumatologie, CHRU Besançon, Besançon, France.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized mainly by arthritis, with the possible occurrence of extra-articular manifestations. We report the case of a patient who developed leptomeningitis as the first sign of RA, one year before the diagnosis of RA. Methylprednisolone 1000 mg was given intravenously. Read More

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Rheumatoid meningitis: A systematic review and meta-analysis.

Eur J Neurol 2021 May 9. Epub 2021 May 9.

Department of Neurology and Neurosurgery, Faculty of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.

Background And Purpose: Rheumatoid meningitis (RM) is a neurological complication of rheumatoid arthritis (RA). Current evidence is based on case reports and partial reviews.

Methods: This is a systematic review and meta-analysis following the PRISMA statement. Read More

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The Effect of Tocilizumab on Inflammatory Markers in Patients Hospitalized with Serious Infections. Case Series and Review of Literature.

Life (Basel) 2021 Mar 20;11(3). Epub 2021 Mar 20.

Department of Rheumatology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

Background: The human anti-IL-6 receptor antibody tocilizumab (TCZ) has been approved for the treatment of rheumatoid arthritis (RA) and giant cell arteritis (GCA). It is observed that CRP levels drop quickly after starting TCZ treatment. This may lead to misinterpretation of laboratory results when accessing the patient with infectious disease while on TCZ. Read More

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Aseptic meningitis in rheumatoid arthritis after anti-TNF administration: a case-based literature review.

Rheumatol Int 2021 Mar 9. Epub 2021 Mar 9.

Division of Rheumatology, Department of Internal Medicine, School of Medicine, Eskişehir Osmangazi University, Eskişehir, 26480, Turkey.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by articular and extra-articular manifestations. Among extra-articular involvement, rheumatoid meningitis (RM) is a rare condition, which may exhibit variable symptoms including headache, focal and/or generalized neurologic deficits. It may develop as the preceding manifestation of RA or occur at any time of the disease course. Read More

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Corticosteroids Contribute to Serious Adverse Events Following Live Attenuated Varicella Vaccination and Live Attenuated Zoster Vaccination.

Vaccines (Basel) 2021 Jan 6;9(1). Epub 2021 Jan 6.

Department of Pediatrics, Division of Infectious Diseases/Virology Laboratory, University of Iowa, Iowa City, IA 52242, USA.

Corticosteroids, when given in high dosages, have long been recognized as a risk factor for severe infection with wild-type varicella-zoster virus in both children and adults. The goal of this review is to assess the degree to which both low-dosage and high-dosage corticosteroids contribute to serious adverse events (SAEs) following live varicella vaccination and live zoster vaccination. To this end, we examined multiple published reports of SAEs following varicella vaccination (Varivax) and zoster vaccination (Zostavax). Read More

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January 2021

Rheumatoid meningitis as a complication of long-standing rheumatoid arthritis: a case treated with rituximab.

Mod Rheumatol Case Rep 2021 Jul 18;5(2):200-205. Epub 2021 Jan 18.

Department of Rheumatology, Ramón y Cajal University Hospital, Madrid, Spain.

Rheumatoid meningitis is a rare complication of long-standing rheumatoid arthritis. We present the case of a 39-year-old Bolivian woman with a history of seropositive rheumatoid arthritis of 12 years of evolution without extra-articular manifestations that develops a severe headache with vomiting. The diagnosis of rheumatoid meningitis was performed based on clinical history, blood count and biochemistry results, cerebrospinal fluid analysis and cranial magnetic resonance imaging findings. Read More

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Unilateral meningitis: unusual central nervous system involvement in rheumatoid arthritis.

Pract Neurol 2020 Nov 28. Epub 2020 Nov 28.

Department of Neurosciences, San Camillo Forlanini Hospital, Roma, Italy.

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November 2020

Leptomeningitis in rheumatoid arthritis.

Eur J Rheumatol 2021 Jan 8;8(1):48-50. Epub 2020 Oct 8.

Faculty of Medical and Allied Health, The University of Sydney Northern Clinical School, Sydney, Australia.

In this case report, we describe the case of a patient given the presumptive diagnosis of rheumatoid leptomeningitis on the basis of clinical findings and clinical response to antirheumatic medications after other causes of meningitis were excluded. Numerous case reports describe rheumatoid meningitis; however, rheumatoid leptomeningitis, in the absence of pachymeningitis, is a rare phenomenon. As such, the literature about it is scant. Read More

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January 2021

Lupus Never Fails to Deceive US: A Case of Rowell's Syndrome.

Case Rep Rheumatol 2020 22;2020:8884230. Epub 2020 Sep 22.

Department of Rheumatology, Mount Sinai Morningside and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Rowell's syndrome is comprised of the presentation of erythema multiforme- (EM-) like lesions in association with lupus erythematosus (LE), along with serologies of speckled antinuclear antibodies (ANAs), positive rheumatoid factor (RF), positive anti-La/anti-Ro, and the clinical finding of chilblains. As per the redefined criteria by Zeitouni et al., three major criteria in addition to at least 1 minor criterion are necessary for diagnosis. Read More

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September 2020

Three cases of rheumatoid meningitis with elevated CSF neopterin levels.

J Neuroimmunol 2020 11 16;348:577396. Epub 2020 Sep 16.

Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan.

Rheumatoid meningitis (RM) is a rare but treatable central nervous system (CNS) manifestation of rheumatoid arthritis (RA) with various clinical presentations and atypical cerebrospinal fluid (CSF) findings. There are no established biomarkers for RM, making diagnosis a challenge. Herein, we present three cases of RM: two patients with RA diagnosis and one without. Read More

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November 2020

Report of four cases of crowned dens syndrome: Clinical presentation, CT findings and treatment.

Exp Ther Med 2020 Oct 21;20(4):3853-3859. Epub 2020 Aug 21.

Department of Minimally Invasive Spinal Surgery, Hubei 672 Orthopaedics Hospital of Integrated Chinese and Western Medicine, Wuhan, Hubei 430079, P.R. China.

The clinical manifestations of crowned dens syndrome (CDS) include acute neck pain and neck stiffness accompanied by restricted cervical range of motion. CDS is frequently misdiagnosed as meningitis, epidural abscess, rheumatoid arthritis, rheumatoid polymyalgia, giant cell arteritis, cervical spondylosis or metastatic bone tumor, and the incidence of CDS appears to be underestimated. The present study reported on four cases of CDS diagnosed by CT. Read More

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October 2020

[Elevation of cerebrospinal fluid anti-cyclic citrullinated peptides antibody index is useful for rheumatoid meningitis preceding neurological symptoms without arthritis: a case report].

Rinsho Shinkeigaku 2020 Sep 8;60(9):631-635. Epub 2020 Aug 8.

Department of Neurology, Nara Medical University.

We report a 62-year-old female with rheumatoid meningitis. She presented with mental disorder, loss of consciousness, generalized seizures, and cognitive impairment. Brain MRI demonstrated high intensity lesions and abnormal enhancement along the left frontal and parietal sulci. Read More

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September 2020

Anti-agalactosyl Immunoglobulin G Antibodies in Probable Rheumatoid Meningitis.

Intern Med 2020 10 7;59(20):2637-2638. Epub 2020 Jul 7.

Department of Neurology, Japanese Red Cross Medical Center, Japan.

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October 2020

Rheumatoid meningitis and infection in absence of rheumatoid arthritis history: review of 31 cases.

Clin Rheumatol 2020 Dec 9;39(12):3833-3845. Epub 2020 Jun 9.

Department of Internal Medicine, Division of Rheumatology, SUNY-Downstate Medical Center, Health & Hospitals Kings County, Brooklyn, NY, 11201, USA.

A 62-year-old healthy male presents with leg weakness and fever. Imaging revealed leptomeningeal enhancement (LE). After cerebrospinal fluid (CSF) cultures were negative, he was discharged with a diagnosis of aseptic meningitis, but was readmitted due to worsening symptoms. Read More

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December 2020

Immunoglobulin G4-related spinal pachymeningitis.

Mousa N Alrashdi

Saudi Med J 2020 Jun;41(6):652-656

Department of Medicine, Collage of Medicine, Qassim University, Al Qassim, Kingdom of Saudi Arabia. E-mail.

Immunoglobulin G4-related disease (IgG4-RD) is rare disease entity and has recently been recognized as an inflammatory disorder with the tendency to affect multiple organs. Pachymeningitis of spine caused by IgG4-related disease is extremely rare. Neck pain and spinal cord compression symptoms consist of usual presentation of IgG4-related spinal pachymeningitis; however, polyarthritis is an unusual presentation of this disease, and it was reported in only one case that mimicked psoriatic arthritis. Read More

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Rheumatoid arthritis with pachymeningitis - a case presentation and review of the literature.

Reumatologia 2020 30;58(2):116-122. Epub 2020 Apr 30.

Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Poland.

Rheumatoid meningitis (RM) is a rare central nervous system (CNS) manifestation of rheumatoid arthritis (RA) with a wide spectrum of symptoms. We present a review of the literature with a rare illustrative case of a 61-year-old man with a history of seropositive rheumatoid arthritis (RA) who presented headaches, stroke-like symptoms and seizures. MRI revealed the leptomeningeal enhancement in the right hemisphere. Read More

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Rheumatoid Meningitis a Rare Extra-Articular Manifestation of Rheumatoid Arthritis: Report of 6 Cases and Literature Review.

J Clin Med 2020 May 27;9(6). Epub 2020 May 27.

Rheumatology department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France.

Objectives: Central neurological manifestations of rheumatoid arthritis (RA) like rheumatoid meningitis (RM) are rare, little known and have a high rate of morbi-mortality.

Methods: We described six cases of RM that were directly related to RA activity after exhaustive assessment.

Results: They were mainly women, aged of 50 to 69. Read More

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Acute-onset focal neurological deficits in rheumatoid arthritis: consider rheumatoid meningitis.

Rheumatology (Oxford) 2020 May 21. Epub 2020 May 21.

Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.

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[Probable rheumatoid meningitis complicated by cryptococcal meningitis: A case report].

Rinsho Shinkeigaku 2020 Jun 19;60(6):429-433. Epub 2020 May 19.

Department of Rheumatology, St. Mary's Hospital, Fukuoka.

We report a case of rheumatoid meningitis complicated with cryptococcal meningitis in a 59-year-old female with rheumatoid arthritis. Migraine symptoms were followed by abnormal behavior, and the patient was admitted with fever and headache. On admission, her cerebrospinal fluid (CSF) contained 115 cells/μl, a protein content of 95 mg/dl, and a sugar level of 47 mg/dl; Her serum anti-cyclic citrullinated peptide (CCP) antibody value was high (174 U/ml), and a brain MRI showed enhanced gadolinium lesions in the cerebral/cerebellar pia mater and subarachnoid space, etc. Read More

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Angiostrongyliasis infection masquerading as granulomatosis with polyangiitis: a case-based review.

Rheumatol Int 2020 Jul 18;40(7):1171-1176. Epub 2020 May 18.

Division of Rheumatology, Allergy and Immunology, Department of Medicine, SUNY Stony Brook University Hospital, Stony Brook, NY, USA.

Pulmonary angiitis is a small vessel vasculitis commonly reported in granulomatosis with polyangiitis (GPA) but is rarely attributed to angiostrongyliasis. We report a case of a patient with well-controlled rheumatoid arthritis, who was treated for GPA based on lung biopsy results with glucocorticoids (GC). Upon re-review of the initial pathology, along with peripheral eosinophilia and history of recent travel, the patient was eventually diagnosed with angiostrongylus-like nematode infection. Read More

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Association Between Tumor Necrosis Factor Inhibitor Exposure and Inflammatory Central Nervous System Events.

JAMA Neurol 2020 08;77(8):937-946

Department of Neurology, Mayo Clinic, Rochester, Minnesota.

Importance: Tumor necrosis factor (TNF) inhibitors are common therapies for certain autoimmune diseases, such as rheumatoid arthritis. An association between TNF inhibitor exposure and inflammatory central nervous system (CNS) events has been postulated but is poorly understood.

Objective: To evaluate whether TNF inhibitor exposure is associated with inflammatory demyelinating and nondemyelinating CNS events in patients with an indication for TNF inhibitor use and to describe the spectrum of those CNS events. Read More

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Rheumatoid Meningitis: Clinical Characteristics, Diagnostic Evaluation, and Treatment.

Neurohospitalist 2020 Apr 30;10(2):88-94. Epub 2019 Jun 30.

Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.

Background And Purpose: Due to the potential for high mortality and neurologic complications of rheumatoid meningitis (RM), awaiting biopsy confirmation may delay vital treatment intervention. Our aim was to describe the clinical presentations of RM in our population and determine whether meningeal biopsy impacted diagnosis, treatment, and outcomes.

Methods: A retrospective chart review was completed for patients at Mayo Clinic with a diagnosis of RM within the last 28 years. Read More

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Anti-cyclic citrullinated peptide antibody in the cerebrospinal fluid in patients with rheumatoid arthritis who have central nervous system involvement.

Clin Rheumatol 2020 Aug 30;39(8):2441-2448. Epub 2020 Apr 30.

National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.

Central nervous system (CNS) involvement, including encephalopathy, encephalitis, leptomeningitis, and pachymeningitis, in rheumatoid arthritis (RA) is rather rare. We report the case of a 61-year-old female with a history of RA in remission for 7 years, who presented with numbness, weakness of the left upper limb, dysarthria, and headache. Magnetic resonance imaging (MRI) of the brain showed meningeal enhancement in the frontal, parietal, and temporal lobes. Read More

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