Document Detail


An unusual central nervous system involvement in rheumatoid arthritis: combination of pachymeningitis and cerebral vasculitis.
MedLine Citation:
PMID:  19093117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe primary central nervous system (CNS) involvement such as vasculitis and pachymeningitis can rarely occur in rheumatoid arthritis (RA) even in the absence of systemic disease activation. The authors illustrate a female patient with well-controlled RA who presented with headaches, encephalopathy, seizures and relapsing focal neurological deficits. Primary rheumatoid cerebral vasculitis and pachymeningitis were diagnosed based on suggestive brain magnetic resonance (MR) imaging, MR angiography, cerebrospinal fluid analysis and cerebral angiography. MR showed abnormal leptomeningeal enhancement and hyperintense FLAIR signal in the cortical subarachnoid spaces consistent with pachymeningitis. Cerebral angiography findings were consistent with vasculitis. Aggressive treatment resulted in significant clinicoradiological resolution. Cerebral vasculitis is a rare but certain manifestation of RA. This complication can be diagnosed in the presence of suggestive angiographic and CSF findings. The condition may be steroid resistant, and needs to be treated more aggressively.
Authors:
Asli Kurne; Rana Karabudak; Omer Karadag; Gül Yalcin-Cakmakli; Kader Karli-Oguz; Kivilcim Yavuz; Meral Calgüneri; Mehmet Akif Topcuoglu
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-12-18
Journal Detail:
Title:  Rheumatology international     Volume:  29     ISSN:  1437-160X     ISO Abbreviation:  Rheumatol. Int.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-18     Completed Date:  2009-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206885     Medline TA:  Rheumatol Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1349-53     Citation Subset:  IM    
Affiliation:
Department of Neurology, Hacettepe University Hospitals, Ankara, Turkey. aokurne@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Arthritis, Rheumatoid / complications*
Electroencephalography
Female
Humans
Magnetic Resonance Imaging
Meningitis / diagnosis,  etiology*,  therapy
Middle Aged
Vasculitis, Central Nervous System / diagnosis,  etiology*,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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