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Rheumatoid meningitis

María J Servioli1, Chandril Chugh, John M Lee

  • 1Department of Neurology, Stritch School of Medicine, Loyola University Chicago Chicago, IL, USA.

Frontiers in Neurology
|January 26, 2012
PubMed

Insights

A rare pachy-leptomeningeal process caused worsening gait and falls in an 80-year-old rheumatoid arthritis patient. Prompt diagnosis and treatment are crucial for managing this condition and improving functional status.

Area of Science:

  • Neurology
  • Rheumatology
  • Radiology

Background:

  • Rheumatoid arthritis (RA) can present with diverse neurological manifestations.
  • Pachy-leptomeningeal disease is a rare complication, particularly in elderly patients.
  • Gait difficulties and falls can be indicative of serious underlying neurological pathology.

Purpose of the Study:

  • To describe a case of pachy-leptomeningeal disease in a patient with rheumatoid arthritis.
  • To highlight the diagnostic challenges and therapeutic strategies for this rare condition.
  • To emphasize the importance of early recognition and intervention.

Main Methods:

  • A comprehensive literature review was conducted.
  • Clinical presentation, neuroimaging findings (MRI), and treatment outcomes were analyzed.
  • The diagnostic and therapeutic approach was discussed in the context of existing literature.

Main Results:

  • An 80-year-old female with RA developed progressive gait impairment and falls.
  • Brain MRI revealed an extra-axial enhancing lesion with contralateral extension.
  • The patient's functional status declined with disease progression.

Conclusions:

  • Pachy-leptomeningeal disease is a critical differential diagnosis in rheumatoid arthritis patients with neurological symptoms.
  • Multimodal diagnostic imaging and a tailored therapeutic approach are essential.
  • Timely management can potentially improve functional outcomes and prevent further deterioration.
Keywords:
brain biopsyrheumatoid arthritisrheumatoid leptomeningitisrheumatoid pachymeningitis

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