Gupta V P, Ehrlich G E
Arthritis Rheum. 1976 Nov-Dec;19(6):1333-8. doi: 10.1002/art.1780190615.
Six patients with seropositive nodule-forming rheumatoid arthritis developed severe central nervous system manifestations consistent with a diagnosis of organic brain syndrome. Organic brain syndrome occurred while 5 of these patients were undergoing corticosteroid withdrawal after prolonged administration. Neuropsychiatric symptoms rapidly cleared, responding to reinstitution of oral or parenteral corticosteroids in large doses in 4 patients, to increase in dosage in 1 patient, and to no drug therapy in the remaining 1. Marked reduction in rheumatoid factor in sera and demonstration of IgM deposits in the choroid plexus in 1 of the patients raised the possibility of immune complex-mediated central nervous system vasculitis.
6例血清学阳性的结节性类风湿关节炎患者出现了与器质性脑综合征诊断相符的严重中枢神经系统表现。其中5例患者在长期使用皮质类固醇后逐渐减药过程中发生了器质性脑综合征。神经精神症状迅速缓解，4例患者通过重新大剂量口服或胃肠外给予皮质类固醇后症状缓解，1例患者通过增加剂量后症状缓解，其余1例患者未接受药物治疗症状也缓解。血清中类风湿因子显著降低，1例患者脉络丛中有IgM沉积，提示免疫复合物介导的中枢神经系统血管炎的可能性。
