Rheumatoid Meningitis Occurring during Etanercept Treatment.
Koji TsuzakiTakashi NakamuraHiroyuki OkumuraNaoko TachibanaToshiaki HamanoPublished in: Case reports in neurological medicine (2017)
We report a 65-year-old man who had repetitive seizures 6 months after receiving etanercept, methotrexate, and prednisolone for rheumatoid arthritis. Mononuclear cells were mildly increased in the cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) showed high intensity along sulci of the frontal and parietal lobes. Brain biopsy revealed lymphocyte and plasma cell infiltration in the meninges, confirming the diagnosis of rheumatoid meningitis. After steroid pulse therapy, seizures resolved and clinical findings improved. When etanercept was replaced by tocilizumab, rheumatoid meningitis did not recur. Although TNF-α inhibitors can control joint symptoms of rheumatoid arthritis, they may induce rheumatoid meningitis.
Keyphrases
- rheumatoid arthritis
- cerebrospinal fluid
- rheumatoid arthritis patients
- disease activity
- high intensity
- magnetic resonance imaging
- ankylosing spondylitis
- resting state
- systemic lupus erythematosus
- juvenile idiopathic arthritis
- functional connectivity
- interstitial lung disease
- single cell
- white matter
- induced apoptosis
- working memory
- contrast enhanced
- peripheral blood
- resistance training
- cell therapy
- computed tomography
- high dose
- cerebral ischemia
- magnetic resonance
- cell cycle arrest
- signaling pathway
- multiple sclerosis
- oxidative stress
- depressive symptoms
- sleep quality
- fine needle aspiration
- bone marrow