Document Detail

Induction of complete and sustained remission of rheumatoid pachymeningitis by rituximab.
MedLine Citation:
PMID:  19479865     Owner:  NLM     Status:  MEDLINE    
Aseptic pachymeningitis is a rare and serious complication of rheumatoid arthritis (RA). Herein, we describe a patient with rheumatoid factor-positive and anti-cyclic citrullinated peptide-positive RA who experienced a focal seizure, with aphasia and convulsions of the right side of the body. The findings of magnetic resonance imaging and histologic analysis led to a diagnosis of rheumatoid pachymeningitis. Because the patient had a large number of CD20-expressing B lymphocytes, therapy with rituximab was started and has resulted in complete and sustained remission of both the pachymeningitis and the RA for >2 years. Despite a decrease in immunoglobulins, the patient has remained free of infections, which illustrates the favorable outcome that can result from therapeutic B cell depletion in this potentially lethal manifestation of RA.
L Schmid; M Müller; T Treumann; W Arnold; B Möller; D Aeberli; P M Villiger
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  60     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-16     Completed Date:  2009-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1632-4     Citation Subset:  AIM; IM    
Kantonsspital, Lucerne, Switzerland.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antigens, CD20 / metabolism
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / complications*,  drug therapy*
B-Lymphocytes / immunology
Magnetic Resonance Imaging
Meningitis / diagnosis,  drug therapy*,  etiology*
Middle Aged
Remission Induction
Treatment Outcome
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antigens, CD20; 0/Antirheumatic Agents; 0/rituximab

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