Possible Cerebral Vasculitis in a Case with Rheumatoid Arthritis
Yosuke Takeuchi1, Shuei Murahashi1, Yasuyuki Hara1
1Department of Neurology, Kumamoto Rosai Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|October 22, 2020
Summary
Cerebral rheumatoid vasculitis (CRV), a rare condition in rheumatoid arthritis patients, presents diagnostic challenges. Early, intensive steroid therapy may be crucial for managing this potentially fatal disorder.
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Cerebral rheumatoid vasculitis (CRV) is a rare, severe complication of rheumatoid arthritis.
- Diagnosis is challenging due to its rarity and non-specific symptoms.
Observation:
- An 81-year-old woman with rheumatoid arthritis presented with fever, altered consciousness, high rheumatoid factor, and hypocomplementemia.
- Imaging revealed enhancement in the left middle cerebral artery's perforating branches, suggesting CRV.
Findings:
- Despite intensified steroid therapy, cerebral lesions showed only temporary improvement.
- Recurrence of CRV in the left frontal lobe led to a fatal outcome.
Implications:
- This case highlights the diagnostic difficulties and aggressive nature of CRV.
- Prompt and intensive treatment strategies are essential for improving outcomes in CRV patients.
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