类风湿性脑膜炎：一例病例报告及文献综述
Rheumatoid meningitis: A case report and review of the literature.
作者信息
Qin Zhaoyi, Kim June, Valencia Damian, Hamoodi Lames, Neltner Jenna, Sizemore Travis, Lightfoot Robert
出版信息
Neurol Clin Pract. 2020 Feb;10(1):73-83. doi: 10.1212/CPJ.0000000000000678.
PURPOSE OF REVIEW
Rheumatoid arthritis is a systemic inflammatory disorder, which can involve many organs; among which, CNS involvement, as in rheumatoid meningitis (RM), is rare and difficult to recognize. Our goal is to present collective data of RM cases to better characterize this disease process and to start new discussions about pathophysiology, diagnosis, and treatment.
RECENT FINDINGS
Since Kato et al., 39 cases of RM have been reported. Approximately 59% were women, presenting with neurologic deficits (56%) and diagnosed by MRI findings, leptomeningeal enhancement (69%), after CSF analysis. Seventy-four percent were treated with corticosteroids, 64% as maintenance therapy, with 46% experiencing improvement or resolution in symptoms without relapse.
SUMMARY
Diagnosis and prognosis of RM has drastically changed since the year 2000. Early detection with CSF and MRI or biopsy findings, coupled with early treatment using corticosteroids and immunologic therapy, has reduced mortality in this population.
综述目的
类风湿关节炎是一种全身性炎症性疾病，可累及多个器官；其中，类风湿性脑膜炎（RM）等中枢神经系统受累情况罕见且难以识别。我们的目标是呈现RM病例的汇总数据，以更好地描述这一疾病过程，并开启关于病理生理学、诊断和治疗的新讨论。
最新发现
自加藤等人以来，已报告39例RM病例。约59%为女性，表现为神经功能缺损（56%），经脑脊液分析后通过MRI检查结果（软脑膜强化，69%）确诊。74%接受了皮质类固醇治疗，64%作为维持治疗，46%的患者症状改善或缓解且无复发。
总结
自2000年以来，RM的诊断和预后发生了巨大变化。通过脑脊液、MRI或活检结果进行早期检测，再加上使用皮质类固醇和免疫疗法进行早期治疗，已降低了该人群的死亡率。
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