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

Clinical Rheumatology
Milena Rodriguez AlvarezIsabel M McFarlane

Abstract

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. Brain biopsy suggested rheumatoid leptomeningitis associated with elevated serum rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA). Following discharge, the New York State Department of Health (NYSDOH) reported a polymerase chain reaction (PCR) on CSF and brain DNA consistent with Naegleria fowleri (NF). After dramatic improvement on steroids, the patient declined antimicrobial treatment. Upon prednisone taper, symptoms recurred which responded to rituximab (RTX). This case highlights a possible association between rheumatoid leptomeningitis (RM) onset and infection, in a patient without a history of rheumatoid arthritis (RA). Our goal is to assess whether this association is present in 69 RM cases reported since 2000. We also describe diagnosis and treatment of 31 new cases (January 2017 to March 2020). We did not identify evidence of active/latent infection in patients with RM and previous RA; however, patients without RA histo...Continue Reading

References

Oct 1, 1975·Annals of Internal Medicine·D D NotmanE M Tan
Jun 26, 2001·Scandinavian Journal of Immunology·S Jeansson, T K Kvien
Jul 19, 2002·The New England Journal of Medicine·Stefan KiechlDavid A Schwartz
Oct 23, 2002·Proceedings of the National Academy of Sciences of the United States of America·Julia Y Wang, Michael H Roehrl
Dec 17, 2003·Clinical Rheumatology·Takashi KatoShu-ichi Ikeda
Mar 24, 2006·AJR. American Journal of Roentgenology·Stephen E JonesMark E Mullins
Oct 6, 2006·Journal of Clinical Microbiology·Yvonne QvarnstromAlexandre J da Silva
Mar 22, 2007·Radiographics : a Review Publication of the Radiological Society of North America, Inc·James G SmirniotopoulosJason W Schroeder
Jan 26, 2012·Frontiers in Neurology·María J ServioliJosé Biller
Aug 25, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jonathan S YoderMichael J Beach
Nov 25, 2014·Neurology. Neuroimmunology and Neuroinflammation·Simona LattanziLeandro Provinciali
Apr 1, 2016·Practical Neurology·Akin NihatBarry Moynihan
Apr 2, 2016·PloS One·Bénédicte Coupat-GoutalandMichel Pélandakis
Sep 2, 2016·Frontiers in Microbiology·Marina I ArleevskayaAnatoly P Tsibulkin
Jan 17, 2017·Clinical & Translational Immunology·Wilhelmina Maria Cornelia TimmermansMenno Cornelis van Zelm
Jan 31, 2017·Nanomedicine : Nanotechnology, Biology, and Medicine·Dominique BerndtCarmen Infante-Duarte
Mar 25, 2017·Rheumatology·Yannick DegboéAdeline Ruyssen-Witrand
Sep 14, 2017·Acta Clinica Belgica·Anneleen MoeyersoonsEllen De Langhe
Nov 13, 2017·Parasitology Research·Moisés Martínez-CastilloMineko Shibayama
Dec 10, 2017·Best Practice & Research. Clinical Rheumatology·Kevin D DeaneV Michael Holers
Jan 14, 2018·BMJ Case Reports·Sian K AlexanderAlberto Cifelli
May 4, 2018·The Neurologist·Angela M ParsonsBrent P Goodman
Aug 12, 2018·Practical Neurology·Michal LubomskiG Michael Halmagyi
Sep 3, 2018·The Journal of Rheumatology·Eleni TiniakouMichelle Petri
Dec 20, 2018·Neurology. Clinical Practice·Simon SchusterTim Magnus
Dec 21, 2018·Reumatismo·E MarcucciR Gerli
Jan 1, 2019·Journal of Neuroimmunology·Cathy Lee ChingChantel Park
Jan 2, 2019·BMJ Case Reports·Nancy Salloum HarrisonVikas Majithia
Jan 13, 2019·BMJ Case Reports·Mary Clare McKennaSimon Cronin
Apr 6, 2019·BMJ Case Reports·Daniel GroseRamesh Sahathevan
May 3, 2019·Journal of Community Hospital Internal Medicine Perspectives·Marianne ScheitelMarc W Nolan
Jul 12, 2019·Frontiers in Neurology·Mette Scheller NissenMorten Blaabjerg
Jul 17, 2019·BioMed Research International·Karolina KotAgnieszka Kolasa-Wołosiuk
Aug 25, 2019·BMJ Case Reports·Kaoru YagitaToshihiko Suenaga
Mar 20, 2020·Neurology. Clinical Practice·Zhaoyi QinRobert Lightfoot
May 5, 2020·Neuroscience Insights·Korri S HershenhouseKetan M Patel

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Citations

May 10, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Eduardo VillaCarlos Guevara

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