Department of Rheumatology, Ramón y Cajal University Hospital, Madrid, Spain.
Department of Neurology, Ramón y Cajal University Hospital, Madrid, Spain.
Mod Rheumatol Case Rep. 2021 Jul;5(2):200-205. doi: 10.1080/24725625.2020.1860439. Epub 2021 Jan 18.
Rheumatoid meningitis is a rare complication of long-standing rheumatoid arthritis. We present the case of a 39-year-old Bolivian woman with a history of seropositive rheumatoid arthritis of 12 years of evolution without extra-articular manifestations that develops a severe headache with vomiting. The diagnosis of rheumatoid meningitis was performed based on clinical history, blood count and biochemistry results, cerebrospinal fluid analysis and cranial magnetic resonance imaging findings. High-dose intravenous glucocorticoids were started, followed by rituximab. After treatment, a significant clinical improvement was observed and repeat magnetic resonance imaging scan confirmed an improvement of the meningeal lesions.
类风湿性脑膜炎是一种罕见的长期类风湿关节炎的并发症。我们报告了一例 39 岁的玻利维亚女性病例，她患有 12 年的血清阳性类风湿关节炎，没有关节外表现，出现严重头痛伴呕吐。根据临床病史、血常规和生化结果、脑脊液分析和头颅磁共振成像结果，诊断为类风湿性脑膜炎。开始使用大剂量静脉注射糖皮质激素，随后使用利妥昔单抗。治疗后，患者的临床症状明显改善，重复磁共振成像扫描证实脑膜病变有所改善。
