Vol.19 No.5

Case Report

Diffuse chronic leptomeningitis with seropositive rheumatoid arthritis: report of a case successfully treated as rheumatoid leptomeningitis

Authors

Kota Shimada¹ , Toshihiro Matsui¹ , Misato Kawakami¹ , Hiromi Hayakawa¹ , Hidekazu Futami¹ , Kazuya Michishita¹ , Hirokazu Takaoka¹ , Tatsuoh Ikenaka¹ , Akiko Komiya¹ , Hisanori Nakayama¹ , Futoshi Hagiwara¹ , Shoji Sugii¹, Hiroshi Furukawa¹, Yoshinori Ozawa¹, Shigeto Tohma¹

Received:

27 January 2009

Accepted:

13 May 2009

Published online:

12 June 2009

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Abstract

A case of biopsy-confirmed chronic leptomeningitis complicating rheumatoid arthritis in a 53-year old female is reported. Her symptoms included weight loss, severe depression, and pyrexia. Magnetic resonance imaging was useful in diagnosis. Intravenous methylprednisolone was prescribed (1 g/day for 3 days), followed by prednisolone (initial dose of 30 mg daily), and this treatment was effective. Her IgG-index, serum levels of soluble interleukin-2 receptor and ferritin, and cerebrospinal level of interleukin-6 paralleled her clinical course.

Key words

Chronic meningitis - Depression - MRI - Rheumatoid arthritis - Rheumatoid meningitis