Recurrent benign lymphocytic (mollaret) meningitis in systemic lupus erythematosus.
BACKGROUND
Aseptic meningitis is one of the most infrequent neuropsychiatric manifestations of systemic lupus erythematosus (SLE) with multifactorial etiologies including medications such as nonsteroidal anti-inflammatory drugs, azathioprine, and trimethoprim-sulfamethoxasole, as well as viruses and malignancy. Recurrent aseptic meningitis in SLE is rare, and remains a diagnostic challenge.


METHODS
We report a unique SLE patient with recurrent (10 episodes), benign (self-limited) lymphocytic aseptic meningitis, which suggests the diagnosis of Mollaret meningitis. There was no prior use of medications known to provoke meningitis. No infectious etiology was identified and chronic meningitis was not observed. The patient had spontaneous resolution of symptoms with no neurologic sequelae.


CONCLUSIONS
Recurrent benign lymphocytic aseptic meningitis is recognized in this SLE patient. We propose that noninfectious Mollaret meningitis be classified as a feature of neuropsychiatric SLE syndromes.
Mikdashi
Jamal
J
Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jmikdash@umaryland.edu
Kennedy
Stacy
S
Krumholz
Allan
A
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D020274:Autoimmune Diseases of the Nervous System / Q000276:immunology / Q000503:physiopathology; D002555:Cerebrospinal Fluid / Q000166:cytology; D006630:Hispanic or Latino; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008578:Meninges / Q000473:pathology* / Q000503:physiopathology; D008582:Meningitis, Aseptic / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology*; D008875:Middle Aged; D020361:Paraneoplastic Syndromes, Nervous System / Q000276:immunology / Q000503:physiopathology; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen