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Rheumatoid pachymeningitis.

H J Tan1, A A Raymond, P P Phadke

  • 1Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia. tanhuijan@hotmail.com

Singapore Medical Journal
|June 29, 2004
PubMed
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Rheumatoid pachymeningitis, a rare rheumatoid arthritis complication, causes non-specific symptoms. This case highlights cerebral MRI as key for diagnosing this condition, even with vague clinical signs.

Area of Science:

  • Neurology
  • Rheumatology
  • Radiology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints.
  • Extra-articular manifestations of RA are diverse and can impact multiple organ systems.
  • Rheumatoid pachymeningitis, inflammation of the dura mater, is an uncommon neurological complication of RA.

Observation:

  • A 61-year-old woman with a 9-year history of rheumatoid arthritis presented with recent onset deafness and progressive disability.
  • Her clinical symptoms were non-specific, posing a diagnostic challenge.
  • The patient's symptoms evolved over a two-month period.

Findings:

  • Cerebral magnetic resonance imaging (MRI) revealed findings consistent with pachymeningitis.
  • Diagnosis of rheumatoid pachymeningitis was established based on imaging results.

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  • The patient's presentation was attributed to this rare extra-articular manifestation of RA.

    • Implications:

    • This case underscores the importance of considering rare neurological complications in RA patients with non-specific symptoms.
    • Cerebral MRI is a crucial diagnostic tool for identifying rheumatoid pachymeningitis.
    • Early diagnosis and appropriate management are essential for improving outcomes in patients with rheumatoid pachymeningitis.