title: Rheumatoid Meningitis Occurring during Etanercept Treatment.
abstract: We report a 65-year-old man who had repetitive seizures 6 months after receiving etanercept, methotrexate, and prednisolone for rheumatoid arthritis. Mononuclear cells were mildly increased in the cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) showed high intensity along sulci of the frontal and parietal lobes. Brain biopsy revealed lymphocyte and plasma cell infiltration in the meninges, confirming the diagnosis of rheumatoid meningitis. After steroid pulse therapy, seizures resolved and clinical findings improved. When etanercept was replaced by tocilizumab, rheumatoid meningitis did not recur. Although TNF-αinhibitors can control joint symptoms of rheumatoid arthritis, they may induce rheumatoid meningitis.
authors.affiliation: Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan.
authors.forename: Koji
authors.identifier: 0000-0002-5364-2280
authors.initials: K
authors.lastname: Tsuzaki
authors.affiliation: Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan; Okumura Clinic, Shiga, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okumura
authors.affiliation: Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Tachibana
authors.affiliation: Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hamano