没有类风湿性关节炎的类风湿性脑膜炎:2例
Juan Yang1, Lu Liu1, Jiahui Peng1
1Department of Neurology, General Hospital of Ningxia Medical University, 804 Shengli Street, Xingqing District, Ningxia, Yinchuan, 750000, China.
BMC neurology
|July 15, 2024
概括
类风湿性脑膜炎 (RM),一种罕见的类风湿性关节炎 (RA) 并发症,呈现出各种症状,使得诊断具有挑战性. 本报告详细介绍了两个没有先前RA史的RM病例,有助于临床识别和管理.
科学领域:
- 神经学 神经学
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性脑膜炎 (RM) 是类风湿性关节炎 (RA) 的罕见的关节外表现.
- 它的各种临床表现使诊断复杂化,缺乏统一的诊断标准.
- 需要进一步调查RM和RA之间的关联.
研究的目的:
- 在没有风湿关节炎病史的患者中报告两例RM病例.
- 突出RM的各种表现所带来的诊断挑战.
- 为 RM 的临床诊断和治疗提供参考资料.
主要方法:
- 两名被诊断患有RM的患者的病例报告.
- 临床评估,包括神经学检查和成像 (大脑MRI).
- 排除其他疾病,如下关节下出血,传染性脑膜炎和典型的RA表现.
主要成果:
- 案例1:一名80岁的妇女在MRI上出现单侧四肢虚弱和膜异常,RA标志物 (CCP, AKA) 升高,但没有先前的RA病史.
- 案例2:一名65岁的男性患有贝尔,特征性脑内成像发现暗示RM,除了面部或RA史/标志物之外,没有神经症状.
- 两名患者在排除传染性脑膜炎和其他原因后被诊断为RM.
结论:
- 在没有先前诊断或明显的类风湿关节炎临床症状的个体中,RM可以发生.
- 早期识别和诊断RM至关重要,即使没有典型的RA特征.
- 这些案例强调了在患有无法解释的神经症状和特征性成像发现的患者中考虑RM的重要性.
相关概念视频
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
01:24Bacterial Meningitis
Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...