title: Aseptic meningitis in relapsing polychondritis: a case report and literature review.
abstract: Aseptic meningitis is an extremely rare neurologic complication of relapsing polychondritis (RP). We reported a case of a 58-year-old Chinese female with intractable headache, puffy ears, pleocytosis, and cranial magnetic resonance imaging (MRI) showing thickened and enhanced meninges. She was finally diagnosed of aseptic meningitis due to RP after full exclusion of infectious causes. She gradually developed neurosensory hearing loss, vertigo, and saddle nose while glucocorticosteroid therapy and combined cyclophosphamide could not control her headache. Ultimately, cyclosporin A was tried showing a good response. Only 18 previous cases were found in the literature and the clinical manifestation, cerebrospinal fluid (CSF) characteristics, imaging features, and therapy considerations of RP-related aseptic meningitis were summarized by reviewing the literature. Aseptic meningitis due to RP is a rare condition of undetermined pathoetiology. Its diagnosis is primarily based on clinical manifestations combined with CSF and MRI examinations plus adequate exclusion of possible infections. Corticosteroid is the basic therapy but choice of protocol should be individualized.
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Shen
authors.affiliation: Department of General Practice, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Geng
authors.initials: G
authors.lastname: Yin
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Chenlu
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, 610041, China. xieqibing1971@163.com.
authors.forename: Qibing
authors.initials: Q
authors.lastname: Xie
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008582:Meningitis, Aseptic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003907:Dexamethasone; D016572:Cyclosporine; D003520:Cyclophosphamide
keywords: Aseptic meningitis; Cerebrospinal fluid; Magnetic resonance imaging; Recurrent polychondritis