Rheumatoid meningitis: A rare cause of unilateral pachymeningitis

Daniel Grose, Matthew Linger, Samara Tinni, Ramesh Sahathevan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

An 87-year-old woman with quiescent rheumatoid arthritis, not on immunosuppressive therapy, presented with unilateral arm weakness, confusion and visual hallucinations. There were no infective symptoms or history of malignancy. Cerebrospinal fluid (CSF) analysis demonstrated lymphocytosis and raised protein, without flow cytometric or cytological abnormalities. Viral, bacterial, mycobacterial and fungal testing of CSF and serum were negative. MRI brain indicated unilateral leptomeningeal enhancement. There was no evidence of occult malignancy on CT imaging of the chest, abdomen and pelvis. Rheumatoid factor and anticyclic citrullinated peptide were strongly positive. The patient declined meningeal biopsy but responded to treatment with corticosteroid therapy.

Original languageEnglish
Article numbere227905
JournalBMJ Case Reports
Volume12
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019
Externally publishedYes

Fingerprint

Meningitis
Cerebrospinal Fluid
Lymphocytosis
Confusion
Rheumatoid Factor
Hallucinations
Immunosuppressive Agents
Pelvis
Abdomen
Rheumatoid Arthritis
Neoplasms
Adrenal Cortex Hormones
Arm
Thorax
Therapeutics
Biopsy
Peptides
Brain
Serum
Proteins

Keywords

  • Neuroimaging
  • Neurology
  • Rheumatoid Arthritis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Grose, D., Linger, M., Tinni, S., & Sahathevan, R. (2019). Rheumatoid meningitis: A rare cause of unilateral pachymeningitis. BMJ Case Reports, 12(4), [e227905]. https://doi.org/10.1136/bcr-2018-227905

Rheumatoid meningitis : A rare cause of unilateral pachymeningitis. / Grose, Daniel; Linger, Matthew; Tinni, Samara; Sahathevan, Ramesh.

In: BMJ Case Reports, Vol. 12, No. 4, e227905, 01.04.2019.

Research output: Contribution to journalArticle

Grose, D, Linger, M, Tinni, S & Sahathevan, R 2019, 'Rheumatoid meningitis: A rare cause of unilateral pachymeningitis', BMJ Case Reports, vol. 12, no. 4, e227905. https://doi.org/10.1136/bcr-2018-227905
Grose, Daniel ; Linger, Matthew ; Tinni, Samara ; Sahathevan, Ramesh. / Rheumatoid meningitis : A rare cause of unilateral pachymeningitis. In: BMJ Case Reports. 2019 ; Vol. 12, No. 4.
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