title: Adhesive arachnoiditis in mixed connective tissue disease: a rare neurological manifestation.
abstract: The overall incidence of neurological manifestations is relatively low among patients with mixed connective tissue disease (MCTD). We recently encountered a case of autoimmune adhesive arachnoiditis in a young woman with 7 years history of MCTD who presented with severe back pain and myeloradiculopathic symptoms of lower limbs. To the best of our knowledge, adhesive arachnoiditis in an MCTD patient has never been previously reported. We report here this rare case, with the clinical picture and supportive ancillary data, including serology, cerebral spinal fluid analysis, electrophysiological evaluation and spinal neuroimaging, that is, MRI and CT (CT scan) of thoracic and lumbar spine. Her neurological deficit improved after augmenting her immunosuppressant therapy. Our case suggests that adhesive arachnoiditis can contribute to significant neurological deficits in MCTD and therefore requires ongoing surveillance.
authors.affiliation: Rheumatology Department, University Hospital Limerick, Limerick, Ireland.|Graduate entry medical school, University of Limerick, Limerick, Ireland.
authors.forename: Maria Usman
authors.identifier: http://orcid.org/0000-0001-7246-4670
authors.initials: MU
authors.lastname: Khan
authors.affiliation: Rheumatology Department, University Hospital Limerick, Limerick, Ireland.
authors.forename: James Anthony Joseph
authors.initials: JA
authors.lastname: Devlin
authors.affiliation: Rheumatology Department, University Hospital Limerick, Limerick, Ireland.|Graduate entry medical school, University of Limerick, Limerick, Ireland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Fraser
mesh_terms: D000328:Adult; D001100:Arachnoiditis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008947:Mixed Connective Tissue Disease / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed