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Meningoencephalitis in relapsing polychondritis: A case report
Haruki Matsumoto1, Ryo Tokimura2, Yuya Fujita1
1Department of Rheumatology.
Medicine
|June 15, 2021
Summary
Aseptic meningoencephalitis, a rare complication of relapsing polychondritis (RP), can cause fever and impaired consciousness. Prompt steroid treatment can lead to rapid improvement and a normal quality of life.
Area of Science:
- Neurology
- Immunology
- Rheumatology
Background:
- Aseptic meningoencephalitis is a rare but serious central nervous system complication associated with relapsing polychondritis (RP).
- Relapsing polychondritis is a systemic autoimmune disease characterized by progressive cartilage destruction.
Observation:
- A 61-year-old male presented with spiking fever and impaired consciousness, indicative of neurological involvement.
- Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, elevated protein, and significantly high interleukin-6 levels.
- Diagnosis of relapsing polychondritis was confirmed by auricular biopsy and clinical criteria, with high anti-type II collagen antibodies detected.
Findings:
- The patient's symptoms rapidly resolved following high-dose steroid pulse therapy (methylprednisolone) and subsequent oral prednisolone.
- Long-term management with a maintenance dose of steroids combined with methotrexate led to a normal quality of life.
Implications:
- Relapsing polychondritis-associated meningoencephalitis requires early consideration in RP patients presenting with unexplained fever and altered consciousness.
- Cerebrospinal fluid interleukin-6 levels may serve as a valuable biomarker for assessing disease activity in RP-related meningoencephalitis.
- This case highlights the efficacy of immunosuppressive therapy in managing this rare neurological complication.
