Kitamura Eiji, Kondo Yuko, Kanazawa Naomi, Akutsu Tsugio, Nishiyama Kazutoshi, Iizuka Takahiro
Department of Neurology, Kitasato University School of Medicine, Japan.
Intern Med. 2019 Apr 1;58(7):1007-1009. doi: 10.2169/internalmedicine.1846-18. Epub 2018 Nov 19.
Autoimmune encephalitis (AE) is an immune-mediated encephalitis characterized by the subacute onset of memory deficits, altered mental status, or psychiatric symptoms. Limbic encephalitis associated with rheumatoid arthritis (RA) has not been reported yet. A 57-year-old man presented with the subacute onset of headache, depression, and anorexia 7 months before the onset of RA. Brain magnetic resonance imaging showed symmetric parenchymal lesions involving the medial temporal lobes. He was diagnosed with RA and AE, but no autoantibodies to neuronal intracellular or cell-surface antigens were identified in either the serum or cerebrospinal fluid. His symptoms improved with immunotherapy. AE can develop as an extra-articular manifestation of RA.
自身免疫性脑炎（AE）是一种免疫介导的脑炎，其特征为记忆缺陷、精神状态改变或精神症状的亚急性发作。与类风湿关节炎（RA）相关的边缘叶脑炎尚未见报道。一名57岁男性在RA发病前7个月出现头痛、抑郁和厌食的亚急性发作。脑磁共振成像显示双侧颞叶内侧实质病变。他被诊断为RA和AE，但血清和脑脊液中均未发现针对神经元细胞内或细胞表面抗原的自身抗体。免疫治疗后他的症状有所改善。AE可作为RA的关节外表现出现。
