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When the plot thickens: a rare complication of rheumatoid arthritis

Identifieur interne : 000300 ( Pmc/Curation ); précédent : 000299; suivant : 000301

When the plot thickens: a rare complication of rheumatoid arthritis

Auteurs : Marianne Scheitel [États-Unis] ; Samuel T. Ives [États-Unis] ; Rawad Nasr [États-Unis] ; Marc W. Nolan [États-Unis]

Source :

RBID : PMC:6484464

Abstract

ABSTRACT

Introduction: Rheumatoid arthritis (RA) is a common illness with many extraarticular manifestations. Rheumatoid pachymeningitis is a rare neurologic complication of this common disease. Here in we present a patient with longstanding RA who developed this uncommon complication.

Case description: A 75-year-old woman with longstanding RA presented to the clinic with multiple seizure-like spells per day. Upon admission to the hospital, brain MRI showed enhancement of the meninges. After an extensive workup for possible other infectious or inflammatory causes, the patient was diagnosed with rheumatoid pachymeningitis.

Conclusion: Rheumatoid pachymeningitis is a rare complication of RA that usually occurs late in the disease course. It may have many neurologic manifestations include mimicking seizure or stroke and must be considered in patients with RA presenting with neurologic symptoms. Pachymeningitis is treated distinctly from articular RA, so early recognition can lead to appropriate treatment.


Url:
DOI: 10.1080/20009666.2019.1593780
PubMed: 31044046
PubMed Central: 6484464

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<bold>Case description</bold>
: A 75-year-old woman with longstanding RA presented to the clinic with multiple seizure-like spells per day. Upon admission to the hospital, brain MRI showed enhancement of the meninges. After an extensive workup for possible other infectious or inflammatory causes, the patient was diagnosed with rheumatoid pachymeningitis.</p>
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<alt-title alt-title-type="running-authors">M. SCHEITEL ET AL.</alt-title>
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<name>
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<sup>a</sup>
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<surname>Ives</surname>
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<sup>b</sup>
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<sup>c</sup>
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<sup>d</sup>
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, Minneapolis, MN,
<country>USA</country>
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<aff id="AFF0002">
<label>b</label>
<institution>Division of General Internal Medicine, Hennepin County Medical Center</institution>
, Minneapolis, MN,
<country>USA</country>
</aff>
<aff id="AFF0003">
<label>c</label>
<institution>Medicine, University of Minnesota</institution>
, Minneapolis, MN,
<country>USA</country>
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<label>d</label>
<institution>Division of Rheumatology, Hennepin County Medical Center</institution>
, Minneapolis, MN,
<country>USA</country>
</aff>
<aff id="AFF0005">
<label>e</label>
<institution>Division of Rheumatology, HealthPartners</institution>
, Saint Paul, MN,
<country>USA</country>
</aff>
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<author-notes>
<corresp id="AN0001">CONTACT Samuel T. Ives
<email xlink:href="samuel.ives@hcmed.org">samuel.ives@hcmed.org</email>
<institution>Division of General Internal Medicine, Hennepin County Medical Center</institution>
,
<addr-line>701 Park Ave S</addr-line>
, Minneapolis, MN55415,
<country>USA</country>
</corresp>
<fn>
<p>All authors listed have contributed sufficiently to the project to be included as authors.</p>
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<day>12</day>
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<year>2019</year>
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<volume>9</volume>
<issue>2</issue>
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<lpage>146</lpage>
<history>
<date date-type="received">
<day>04</day>
<month>12</month>
<year>2018</year>
</date>
<date date-type="accepted">
<day>07</day>
<month>3</month>
<year>2019</year>
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<copyright-statement>© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.</copyright-statement>
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<copyright-holder>The Author(s)</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
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</license>
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<abstract>
<title>ABSTRACT</title>
<p>
<bold>Introduction</bold>
: Rheumatoid arthritis (RA) is a common illness with many extraarticular manifestations. Rheumatoid pachymeningitis is a rare neurologic complication of this common disease. Here in we present a patient with longstanding RA who developed this uncommon complication.</p>
<p>
<bold>Case description</bold>
: A 75-year-old woman with longstanding RA presented to the clinic with multiple seizure-like spells per day. Upon admission to the hospital, brain MRI showed enhancement of the meninges. After an extensive workup for possible other infectious or inflammatory causes, the patient was diagnosed with rheumatoid pachymeningitis.</p>
<p>
<bold>Conclusion</bold>
: Rheumatoid pachymeningitis is a rare complication of RA that usually occurs late in the disease course. It may have many neurologic manifestations include mimicking seizure or stroke and must be considered in patients with RA presenting with neurologic symptoms. Pachymeningitis is treated distinctly from articular RA, so early recognition can lead to appropriate treatment.</p>
</abstract>
<kwd-group kwd-group-type="author">
<title>KEYWORDS</title>
<kwd>Rheumatoid arthritis</kwd>
<kwd>meningitis</kwd>
<kwd>pachymeningitis</kwd>
</kwd-group>
<funding-group>
<funding-statement>none</funding-statement>
</funding-group>
<counts>
<fig-count count="2"></fig-count>
<ref-count count="10"></ref-count>
<page-count count="4"></page-count>
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