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• Vol.56 No.9
• CLINICA NEUROL, 56: 627−632, 2016
• Vol.56 No.9 contents

Case Report

A case of anti-cyclic citrullinated peptides antibody positive rheumatoid meningitis without arthritis at the onset of neurological symptoms

Tetsuya Abe, M.D.¹⁾, Kazuhiko Mishima, M.D., Ph.D.²⁾, Akira Uchino, M.D., Ph.D.³⁾, Atsushi Sasaki, M.D., Ph.D.⁴⁾, Norio Tanahashi, M.D., Ph.D.¹⁾ and Masaki Takao, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Saitama Medical University International Medical Center
²⁾Department of Neurosurgery, Saitama Medical University International Medical Center
³⁾Department of Radiology, Saitama Medical University International Medical Center
⁴⁾Department of Pathology, Saitama Medical University Hospital

We report an 84-year-old woman with rheumatoid meningitis. She developed weakness in her muscles and became cognitively impaired. However, physical examination revealed no evidence of rheumatoid arthritis. Levels of anti-cyclic citrullinated peptide antibodies were elevated. Brain magnetic resonance imaging (MRI) showed hyperintense lesions in the frontotemporoparietal subarachnoid space on fluid attenuated inversion recovery (FLAIR) images. Leptomeningeal enhancement was also evident on gadolinium-enhanced T₁-weighted images. We suspected rheumatoid meningitis. A brain biopsy was performed and methylprednisolone pulse therapy was started. Subsequently, her symptoms and MRI findings rapidly improved.
Full Text of this Article in Japanese PDF (705K)

(CLINICA NEUROL, 56: 627−632, 2016)
key words: rheumatoid meningitis, rheumatoid arthritis, anti-cyclic citrullinated peptide antibody

(Received: 18-May-16)