An unusual presentation of rheumatoid meningitis

Vaidehi Chowdhry, Neeraj Kumar, Daniel H. Lachance, Diva R. Salomao, Harvinder S. Luthra

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background. Central nervous system involvement in rheumatoid arthritis can rarely occur in the absence of systemic disease. Rheumatoid meningitis has not been reported to present as spells of neurologic dysfunction. Patient and Methods. The authors describe a woman with a history of well-controlled rheumatoid arthritis who presented with headaches and spells of focal neurological dysfunction. Brain magnetic resonance imaging, brain biopsy, and temporal artery biopsy were required to make the diagnosis of rheumatoid meningitis with arteritis. Results. Neuroimaging revealed abnormal leptomeningeal enhancement. Necrotizing granulomatous inflammation was seen on meningeal and brain biopsy. A temporal artery biopsy showed evidence of arteritis without giant cells. Conclusions. The possibility of central nervous system involvement by rheumatoid arthritis should be considered in patients with a history of rheumatoid arthritis even in the absence of systemic symptoms. Making the diagnosis may require meningeal and brain biopsy. The condition may be steroid responsive.

Original languageEnglish (US)
Pages (from-to)286-288
Number of pages3
JournalJournal of Neuroimaging
Volume15
Issue number3
DOIs
StatePublished - Jul 1 2005

Keywords

  • Meningitis
  • Rheumatoid arthritis
  • Spells

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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