Hirano Kazuoki, Fukae Jiro, Hieda Sotaro, Fujimaki Motoki, Ishii Hisato, Tsuboi Yoshio, Kawamura Mitsuru, Arai Hajime, Hattori Nobutaka
Department of Neurology, Juntendo University School of Medicine, Japan.
Intern Med. 2013;52(12):1393-6. doi: 10.2169/internalmedicine.52.9578.
Eosinophilic meningitis is defined as the presence of 10 eosinophils/mm(3) in the cerebrospinal fluid (CSF) or eosinophils accounting for more than 10% of CSF leukocytes. A 76-year-old man who developed cognitive dysfunction and consciousness disturbance had eosinophilic meningitis (his CSF contained 19.0% eosinophils). Because the etiology was unknown, we performed a brain biopsy. The pathological findings showed inflammatory infiltration in the small-sized arteries of the meninges. The patient was ultimately diagnosed as having primary angiitis of the central nervous system (PACNS). Eosinophilic meningitis occurring in a patient with PACNS is extremely rare, and this is the first report of this condition in Japan.
嗜酸性粒细胞性脑膜炎的定义为脑脊液(CSF)中嗜酸性粒细胞计数达到10个/立方毫米,或嗜酸性粒细胞占CSF白细胞的比例超过10%。一名76岁出现认知功能障碍和意识障碍的男性患有嗜酸性粒细胞性脑膜炎(其CSF中嗜酸性粒细胞占19.0%)。由于病因不明,我们进行了脑活检。病理结果显示脑膜小动脉有炎症浸润。该患者最终被诊断为中枢神经系统原发性血管炎(PACNS)。PACNS患者发生嗜酸性粒细胞性脑膜炎极为罕见,这是日本关于这种情况的首例报告。