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Rheumatoid nodulosis of the meninges

N E Karam1, L Roger, L L Hankins

  • 1Department of Medicine, University of Texas Houston Health Science Center, Houston 77225.

Insights

Leptomeningeal rheumatoid nodulosis, a rare brain complication, occurred in a patient with mild rheumatoid arthritis (RA) during methotrexate treatment. This case highlights a rare presentation of RA affecting the central nervous system.

Area of Science:

  • Neurology
  • Rheumatology
  • Pathology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints.
  • Neurological complications of RA are uncommon, with rheumatoid nodulosis typically seen in severe, deforming cases.
  • Leptomeningeal involvement by rheumatoid nodules is exceptionally rare.

Observation:

  • A case of leptomeningeal rheumatoid nodulosis is presented.
  • The patient had non-deforming rheumatoid arthritis.
  • The condition occurred during methotrexate therapy.

Findings:

  • This case demonstrates rheumatoid nodulosis affecting the brain's leptomeninges.
  • The presentation occurred in a patient with mild, non-deforming rheumatoid arthritis.
  • Methotrexate therapy was being administered at the time of diagnosis.

Implications:

  • This finding expands the known spectrum of central nervous system involvement in rheumatoid arthritis.
  • It suggests that leptomeningeal rheumatoid nodulosis can occur even in less severe forms of RA.
  • The role of methotrexate in the pathogenesis or presentation of this rare complication warrants further investigation.

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