Rheumatology International

, Volume 31, Issue 10, pp 1383–1385 | Cite as

Unusual central nervous system involvement of rheumatoid arthritis: successful treatment with steroid and azathioprine

  • Asuman Sengoz Inan
  • Seval Masatlıoglu
  • Seyfi C. Ozyurek
  • Derya Engin
  • Ilknur Erdem
Case Report
First Online:
Received:
Accepted:

Abstract

Central nervous system involvement of rheumatoid arthritis (RA) frequently develops in patients who had a long-term history of RA, irrespective of the disease activity of systemic arthritis, and it has a high mortality rate despite treatment. Since clinical symptoms and radiologic signs are rather nonspecific, in short of doing biopsy, the diagnosis of rheumatoid meningitis is one of exclusion. However, the strongly positive rheumatoid factor in the cerebrospinal fluid is quite specific. We here report a 70-year-old man who had not been diagnosed as RA before he was admitted with neurological findings, who was diagnosed as RA later and successfully treated with prednisolone and azathioprine.

Keywords

Rheumatoid arthritis Rheumatoid factor Prednisolone Azathioprine 
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References

  1. 1.
    Bathon JM, Moreland LW, DiBartolomeo AG (1989) Inflammatory central nervous system involvement in rheumotoid arthritis. Semin Arthritis Rheum 18:258–266PubMedCrossRefGoogle Scholar
  2. 2.
    Kato T, Hoshi K, Sekijima Y, Matsuda M, Hashimato T, Otani M, Suzuki A, Ikeda S (2003) Rheumatoid meningitis: an autopsy report and review of the literature. Clin Rhematol 22:475–480CrossRefGoogle Scholar
  3. 3.
    Tan HJ, Raymond AA, Phadke PP, Rozman Z (2004) Rheumatoid pachymeningitis. Singapore Med J 45(7):337–339PubMedGoogle Scholar
  4. 4.
    Markenson JA, McDougal JS, Tsairis P, Lockshin MD, Christian CL (1979) Rheumatoid meningitis: a localised immune process. Ann Intern Med 90:786–789PubMedGoogle Scholar
  5. 5.
    Kanemoto M, Ota Yasuhiro, Karahashi T, Nozue N (2005) A case of idiopathic hypertrophic cranial pacymeningitis manifested only by positive rheumatoid factor and abnormal findings of the anterior falx. Rheumatol Int 25:230–233PubMedCrossRefGoogle Scholar
  6. 6.
    Starosta MA, Brandwein SR (2007) Clinical manifestation and treatment of rheumatoid pachymeningitis. Neurology 68:1079–1080PubMedCrossRefGoogle Scholar
  7. 7.
    Yücel AE, Kart H, Aydın P, Ağildere AM, Benli S, Altinörs N, Demirhan B (2001) Pachymeningitis and optic neuritis in rheumatoid arthritis: successful treatment with cyclofosfamide. Clin Rheumatol 20:136–139PubMedCrossRefGoogle Scholar
  8. 8.
    Chou RC, Henson JW, Tian D, Hedley-Whyte ET, Reginato AM (2006) Successful treatment of rheumatoid meningitis with cyclofosfamide but not infliximab. Ann Rheum Dis 65:1114–1116PubMedCrossRefGoogle Scholar
  9. 9.
    Claassen J, Dwyer E, Maybaum S, Elkind MSV (2006) Rheumatoid leptomeningitis after heart transplantation. Neurology 66:948–949PubMedCrossRefGoogle Scholar
  10. 10.
    Karam NE, Roger L, Hankins LL, Reveille JD (1994) Rheumatoid nodules of the meninges. J Rheumatol 21:1960–1963PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Asuman Sengoz Inan
    • 1
    • 4
  • Seval Masatlıoglu
    • 2
  • Seyfi C. Ozyurek
    • 1
  • Derya Engin
    • 1
  • Ilknur Erdem
    • 3
  1. 1.Department of Infectious Diseases and Clinical MicrobiologyHaydarpasa Numune Training and Research HospitalIstanbulTurkey
  2. 2.Department of RheumatologyHaydarpasa Numune Training and Research HospitalIstanbulTurkey
  3. 3.Department of Infectious Diseases and Clinical MicrobiologyNamık Kemal UniversityTekirdagTurkey
  4. 4.IstanbulTurkey

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