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Acute posterior multifocal placoid pigment epitheliopathy presenting as an aseptic meningitis

M Manto1, M Cordonnier, S Blecic

  • 1Service de Neurologie et, 808, Route de Lennik, 1070 Bruxelles, BelgiumOphthalmologie, Hopital Erasme, Université libre de Bruxelles, 808, Route de Lennik, 1070 Bruxelles, Belgium.

European Journal of Neurology
|November 29, 2013
PubMed

Insights

A patient with acute posterior multifocal placoid pigment epitheliopathy experienced aseptic meningitis. This condition responded well to steroids, suggesting a systemic autoimmune disease with unusual biological markers.

Area of Science:

  • Ophthalmology
  • Neurology
  • Rheumatology

Background:

  • Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory eye condition.
  • APMPPE can rarely present with neurological symptoms, mimicking meningitis.

Purpose of the Study:

  • To describe a unique case of APMPPE presenting as aseptic meningitis.
  • To explore the potential systemic autoimmune etiology of this presentation.

Main Methods:

  • Case report of a 33-year-old patient.
  • Clinical examination and laboratory investigations including erythrocyte sedimentation rate, immunocomplex detection, cerebrospinal fluid analysis for oligoclonal banding, and urinalysis.
  • Monitoring of response to corticosteroid therapy.

Main Results:

  • The patient presented with symptoms consistent with aseptic meningitis.
  • Biological abnormalities included elevated erythrocyte sedimentation rate, circulating immunocomplexes, cerebrospinal fluid oligoclonal banding, and transient abnormal urine sediment.
  • The patient showed a prompt positive response to corticosteroid treatment.

Conclusions:

  • The clinical presentation and laboratory findings support a diagnosis of systemic autoimmune disease.
  • APMPPE can manifest with neurological involvement, indicating a broader systemic inflammatory process.

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