Diffuse chronic leptomeningitis with seropositive rheumatoid arthritis: report of a case successfully treated as rheumatoid leptomeningitis.
A case of biopsy-confirmed chronic leptomeningitis complicating rheumatoid arthritis in a 53-year old female is reported. Her symptoms included weight loss, severe depression, and pyrexia. Magnetic resonance imaging was useful in diagnosis. Intravenous methylprednisolone was prescribed (1 g/day for 3 days), followed by prednisolone (initial dose of 30 mg daily), and this treatment was effective. Her IgG-index, serum levels of soluble interleukin-2 receptor and ferritin, and cerebrospinal level of interleukin-6 paralleled her clinical course.
Shimada
Kota
K
Department of Rheumatology, National Hospital Organization Sagamihara Hospital, 18-1 Sakura-dai, Sagamihara, Kanagawa, 228-8522, Japan. k-shimada@sagamihara-hosp.gr.jp
Matsui
Toshihiro
T
Kawakami
Misato
M
Hayakawa
Hiromi
H
Futami
Hidekazu
H
Michishita
Kazuya
K
Takaoka
Hirokazu
H
Ikenaka
Tatsuoh
T
Komiya
Akiko
A
Nakayama
Hisanori
H
Hagiwara
Futoshi
F
Sugii
Shoji
S
Furukawa
Hiroshi
H
Ozawa
Yoshinori
Y
Tohma
Shigeto
S
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D001921:Brain / Q000473:pathology; D002908:Chronic Disease / Q000188:drug therapy; D016207:Cytokines / Q000097:blood; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008581:Meningitis / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010841:Pia Mater / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D015375:Receptors, Interleukin-2 / Q000097:blood; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D016207:Cytokines; D015375:Receptors, Interleukin-2; D005293:Ferritins; D011239:Prednisolone; D008775:Methylprednisolone