11/21. west nile virus meningitis in a chronic immunosuppressed patient with rheumatoid arthritis.The clinical presentation of west nile virus (WNV) can be severe in immunosuppressed patients. A 65-year-old with steroid-dependent rheumatoid arthritis on infliximab and methotrexate presented with meningitis and profound muscular weakness. serum WNV IgM and IgG antibody were positive. WNV should be included in the differential diagnosis of neurological symptoms in peak months.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
12/21. An unusual presentation of rheumatoid meningitis.BACKGROUND: central nervous system involvement in rheumatoid arthritis can rarely occur in the absence of systemic disease. Rheumatoid meningitis has not been reported to present as spells of neurologic dysfunction. PATIENT AND methods: The authors describe a woman with a history of well-controlled rheumatoid arthritis who presented with headaches and spells of focal neurological dysfunction. brain magnetic resonance imaging, brain biopsy, and temporal artery biopsy were required to make the diagnosis of rheumatoid meningitis with arteritis. RESULTS: neuroimaging revealed abnormal leptomeningeal enhancement. Necrotizing granulomatous inflammation was seen on meningeal and brain biopsy. A temporal artery biopsy showed evidence of arteritis without giant cells. CONCLUSIONS: The possibility of central nervous system involvement by rheumatoid arthritis should be considered in patients with a history of rheumatoid arthritis even in the absence of systemic symptoms. Making the diagnosis may require meningeal and brain biopsy. The condition may be steroid responsive.- - - - - - - - - - ranking = 1.2keywords = meningitis (Clic here for more details about this article) |
13/21. Hypertrophic pachymeningitis in rheumatoid arthritis after adalimumab administration.Tumor necrosis factor-a (TNF-a) inhibition, used in the treatment of rheumatoid arthritis (RA), is associated with central nervous system (CNS) events including new onset and/or exacerbations of pre-existing demyelinating neurological diseases. We describe a patient with refractory RA where adalimumab, a fully humanized IgG1 monoclonal antibody against TNF-a, may have contributed to the development of meningoencephalitis, with brain biopsy suggestive of hypertrophic pachymeningitis, a rare complication of this disease. The patient had recurrence of neurological symptoms upon repeated administration of adalimumab, and resolution of symptoms after withdrawal.- - - - - - - - - - ranking = 150.13061791383keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
14/21. Inflammatory central nervous system involvement in rheumatoid arthritis.We describe a patient with seropositive rheumatoid arthritis who developed pachymeningitis resulting in optic atrophy. Clinical, histopathologic, and radiologic findings in 18 additional cases of inflammatory CNS disease associated with rheumatoid arthritis are reviewed. The three characteristic neuropathologic findings were rheumatoid nodules, pachymeningitis or leptomeningitis, and vasculitis. In most cases, more than one of these histopathologic processes were found. The typical host was middle-aged with long-standing severe nodular disease. However, contrary to previous reports, CNS disease occurred in a significant number of patients without active synovitis and extracranial vasculitis and nodules. Although no correlation between specific neurologic symptoms and neuropathology was noted, patients with CNS nodules tended to be asymptomatic more often than patients with vasculitis or meningitis. CSF analysis and computed axial tomography were helpful diagnostic tools, but diagnosis was ultimately made only by directed biopsy or at autopsy. Treatment with surgical decompression and/or corticosteroids has proved beneficial in several cases. Inflammatory CNS involvement in rheumatoid arthritis should be considered in any patient with neurologic symptoms in whom infectious and malignant processes are ruled out. An aggressive, invasive approach for diagnostic biopsies seems warranted.- - - - - - - - - - ranking = 60.452247165533keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
15/21. Rheumatoid meningitis: a localized immune process.Rheumatoid pachymeningitis is a rare complication of rheumatoid arthritis. This disease was confined to the dura and pia-arachnoid of the lumbar cord in our patient. Her neurologic deficits responded to surgical decompression and corticosteroid therapy. Radiologic evidence and the differences in cell count, protein, and glucose content between lumbar and cisternal cerebrospinal fluid indicate that rheumatoid pachymeningitis can be localized to a discrete region of the central nervous system. Elevated immunoglobulins, IgM and IgG rheumatoid factors, low molecular weight IgM, and immune complexes were found in the cerebrospinal fluid and implicate an immune reaction in the pathogenesis of this disease, which is probably similar to inflammatory processes involving other organs in rheumatoid arthritis.- - - - - - - - - - ranking = 60.852247165533keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
16/21. gallium imaging of rheumatoid pachymeningitis.A case of abnormal uptake of gallium in the tentorium cerebelli secondary to rheumatoid pachymeningitis is presented.- - - - - - - - - - ranking = 150.13061791383keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
17/21. adult septic arthritis with Hemophilus influenzae.Two cases of Hemophilus influenzae septic arthritis are reported, one in a rheumatoid patient and the other in a healthy young woman after meningitis. The evolution of this rare infectious arthritis was not as good as usual in spite of early therapy. The first patient later presented a Staphylococcus albus bacteriemia and the other a post-infectious persisting arthritis.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
18/21. Pyogenic infection and rheumatoid arthritis.Ten episodes of severe pyogenic infection occurring in nine patients with rheumatoid arthritis are reported. There was a wide range of presenting features including pyoarthrosis in 7 episodes. Three cases presented with meningitis, bacterial endocarditis and probable multiple abscesses respectively. infection was caused by staphylococcus aureus in 7 episodes and by staphylococcus epidermidis, streptococcus pneumoniae and beta-haemolytic Streptococcus in each of one episode. Three infective episodes were fatal. Pyogenic, especially staphylococcal, infection should be considered in patients with rheumatoid arthritis with unexplained illness with or without sudden deterioration in joint symptoms. It is important to recognize and treat infection rapidly.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
19/21. Rheumatoid meningitis. A case report and review of the literature.Focal rheumatoid inflammation of the dura and leptomeninges was found in an 89-year-old man who was neurologically asymptomatic and had clinically inactive rheumatoid disease. Previous reports of this entity have not stressed that rheumatoid meningitis can be virtually asymptomatic and can develop in persons with apparently quiescent joint disease. The presence of vasculitis of the meningeal or cerebral vessels is associated with symptoms. Intracranial rheumatoid lesions were associated with rheumatoid lesions in other organs, especially the heart and lungs.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
20/21. Treatment of rheumatoid pachymeningitis involving the entire thoracic region.A 67-year-old woman developed a spinal cord compression syndrome due to rheumatoid pachymeningitis with a roentgenological block from T2 to T11. The dura was surgically split from T1 to T12 and carefully dissected away from the spinal cord and then left open without grafting. The patient imporved and 3 years after the operation the spinal subarachnoid space and the circulation of cerebrospinal fluid were normal.- - - - - - - - - - ranking = 150.13061791383keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
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