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Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis

Rheumatoid meningoencephalitis (RM) is a rare complication of rheumatoid arthritis (RA). This report describes a 63-year-old man with complaints of high-grade fever, headache, and vomiting for several days before admission. Both his serum and cerebrospinal fluid were positive for anti-cyclic citrull...

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Autores principales: Shibahara, Tomoya, Matsushita, Tomonaga, Matsuo, Ryu, Fukushima, Yoshihisa, Fukuda, Kenji, Sugimori, Hiroshi, Kamouchi, Masahiro, Kitazono, Takanari, Ago, Tetsuro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5043166/
https://www.ncbi.nlm.nih.gov/pubmed/27721779
http://dx.doi.org/10.1159/000447627
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author Shibahara, Tomoya
Matsushita, Tomonaga
Matsuo, Ryu
Fukushima, Yoshihisa
Fukuda, Kenji
Sugimori, Hiroshi
Kamouchi, Masahiro
Kitazono, Takanari
Ago, Tetsuro
author_facet Shibahara, Tomoya
Matsushita, Tomonaga
Matsuo, Ryu
Fukushima, Yoshihisa
Fukuda, Kenji
Sugimori, Hiroshi
Kamouchi, Masahiro
Kitazono, Takanari
Ago, Tetsuro
author_sort Shibahara, Tomoya
collection PubMed
description Rheumatoid meningoencephalitis (RM) is a rare complication of rheumatoid arthritis (RA). This report describes a 63-year-old man with complaints of high-grade fever, headache, and vomiting for several days before admission. Both his serum and cerebrospinal fluid were positive for anti-cyclic citrullinated peptide (CCP) antibody and rheumatoid factor, and contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging (MRI) showed abnormal gadolinium enhancement of the meninges and high-intensity lesions in the subarachnoid spaces. The patient was diagnosed with RM despite lack of signs suggesting RA. His symptoms drastically improved with intravenous infusion of high-dose methylprednisolone. Two months later, he developed RA. The findings in this patient suggest that RM could develop prior to the onset of RA. Anti-CCP antibody and MRI findings may be useful for the diagnosis of RM, regardless of RA history.
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spelling pubmed-50431662016-10-07 Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis Shibahara, Tomoya Matsushita, Tomonaga Matsuo, Ryu Fukushima, Yoshihisa Fukuda, Kenji Sugimori, Hiroshi Kamouchi, Masahiro Kitazono, Takanari Ago, Tetsuro Case Rep Neurol Case Report Rheumatoid meningoencephalitis (RM) is a rare complication of rheumatoid arthritis (RA). This report describes a 63-year-old man with complaints of high-grade fever, headache, and vomiting for several days before admission. Both his serum and cerebrospinal fluid were positive for anti-cyclic citrullinated peptide (CCP) antibody and rheumatoid factor, and contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging (MRI) showed abnormal gadolinium enhancement of the meninges and high-intensity lesions in the subarachnoid spaces. The patient was diagnosed with RM despite lack of signs suggesting RA. His symptoms drastically improved with intravenous infusion of high-dose methylprednisolone. Two months later, he developed RA. The findings in this patient suggest that RM could develop prior to the onset of RA. Anti-CCP antibody and MRI findings may be useful for the diagnosis of RM, regardless of RA history. S. Karger AG 2016-07-20 /pmc/articles/PMC5043166/ /pubmed/27721779 http://dx.doi.org/10.1159/000447627 Text en Copyright © 2016 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Shibahara, Tomoya
Matsushita, Tomonaga
Matsuo, Ryu
Fukushima, Yoshihisa
Fukuda, Kenji
Sugimori, Hiroshi
Kamouchi, Masahiro
Kitazono, Takanari
Ago, Tetsuro
Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title_full Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title_fullStr Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title_full_unstemmed Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title_short Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis
title_sort anti-cyclic citrullinated peptide antibody-positive meningoencephalitis in the preclinical period of rheumatoid arthritis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5043166/
https://www.ncbi.nlm.nih.gov/pubmed/27721779
http://dx.doi.org/10.1159/000447627
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