title: Granulomatous meningitis due to rheumatoid arthritis.
abstract: Meningoencephalitis is a rare but aggressive complication of rheumatoid arthritis (RA). The most common complications of RA occur in the severe and chronic stages of the disease. Only a few cases have been reported in the literature. The symptoms are usually nonspecific, and arthralgia may be missing. Brain MRI and CSF analysis are useful to guide the diagnosis. However, a biopsy is required to demonstrate the existence of granulomatous lesions and the lack of mycobacterium infection. Early detection is essential to prevent neurological complications. Treatment consists of intravenous high doses of corticoid followed by oral tapered doses associated with immunosuppressive therapy. The present case is remarkable by the presence of granulomatous lesions in the lung and meninges and the dramatic improvement after immunosuppressive therapy.
authors.affiliation: Department of Neurology, CHU Mont-Godinne, Université Catholique de Louvain (UCL), Avenue Gaston Therasse, 5530 Yvoir, Belgium.
authors.forename: Marie Céline
authors.initials: MC
authors.lastname: Duray
authors.forename: Eric
authors.initials: E
authors.lastname: Marchand
authors.forename: Sophie
authors.initials: S
authors.lastname: Gohy
authors.forename: Birgit
authors.initials: B
authors.lastname: Weynand
authors.forename: Béatrice
authors.initials: B
authors.lastname: De Coene
authors.forename: Patrice
authors.initials: P
authors.lastname: Laloux
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001921:Brain / Q000473:pathology; D006099:Granuloma / Q000150:complications / Q000209:etiology*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000150:complications / Q000209:etiology*; D013116:Spinal Cord / Q000473:pathology