Diffuse chronic leptomeningitis with seropositive rheumatoid arthritis: report of a case successfully treated as rheumatoid leptomeningitis

Mod Rheumatol. 2009;19(5):556-62. doi: 10.1007/s10165-009-0186-9. Epub 2009 Jun 12.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / pathology
  • Brain / pathology
  • Chronic Disease / drug therapy
  • Cytokines / blood
  • Disease Progression
  • Drug Administration Schedule
  • Female
  • Ferritins / blood
  • Humans
  • Magnetic Resonance Imaging
  • Meningitis / blood
  • Meningitis / complications*
  • Meningitis / drug therapy*
  • Meningitis / pathology
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Pia Mater / pathology
  • Prednisolone / therapeutic use
  • Receptors, Interleukin-2 / blood
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Receptors, Interleukin-2
  • Ferritins
  • Prednisolone
  • Methylprednisolone