Aseptic meningitis in mixed connective tissue disease: cytokine and anti-U1RNP antibodies in cerebrospinal fluids from two different cases.
In this paper, we report two patients with mixed connective tissue disease (MCTD) who developed aseptic meningitis. In both cases, the concentrations of IFN-gamma and IL-6 in cerebrospinal fluid (CSF) were increased. In the first case, with non-steroidal anti-inflammatory drugs (NSAIDs)-induced meningitis, where anti-U1RNP antibodies (Abs) were not detected in CSF, NSAIDs induced both IFN-gamma and IL-6 secretion from peripheral blood mononuclear cells in vitro. In the second case, with disease-associated meningitis, anti-U1RNP Abs were detected also in CSF. Of note, anti-U1RNP Abs appeared to be more concentrated in CSF than in serum and CSF-anti-U1RNP Ab titer was correlated with disease activity. We suggest that IFN-gamma and IL-6 may be involved in both disease-associated and drug-induced aseptic meningitis, whereas CSF-anti-U1RNP Abs is detected only in a patient with MCTD-associated aseptic meningitis.
Fujita
Yoshimasa
Y
Department of Rheumatology, Utano National Hospital, Kyoto, Japan.
Fujii
Takao
T
Nakashima
Ran
R
Tanaka
Masao
M
Mimori
Tsuneyo
T
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001323:Autoantibodies / Q000276:immunology*; D002478:Cells, Cultured; D016207:Cytokines / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000134:cerebrospinal fluid; D015847:Interleukin-4 / Q000134:cerebrospinal fluid; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000276:immunology*; D008947:Mixed Connective Tissue Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D017412:Ribonucleoprotein, U1 Small Nuclear / Q000276:immunology*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001323:Autoantibodies; D016207:Cytokines; D015850:Interleukin-6; D017412:Ribonucleoprotein, U1 Small Nuclear; D015847:Interleukin-4; D007371:Interferon-gamma; D011239:Prednisolone