title: Organic brain syndrome in rheumatoid arthritis following corticosteroid withdrawal.
abstract: Six patients with seropositive nodule-forming rheumatoid arthritis developed severe central nervous system manifestations consistent with a diagnosis of organic brain syndrome. Organic brain syndrome occurred while 5 of these patients were undergoing corticosteroid withdrawal after prolonged administration. Neuropsychiatric symptoms rapidly cleared, responding to reinstitution of oral or parenteral corticosteroids in large doses in 4 patients, to increase in dosage in 1 patient, and to no drug therapy in the remaining 1. Marked reduction in rheumatoid factor in sera and demonstration of IgM deposits in the choroid plexus in 1 of the patients raised the possibility of immune complex-mediated central nervous system vasculitis.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D001927:Brain Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome
chemical_list: D000305:Adrenal Cortex Hormones; D011241:Prednisone