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Meningoencephalitis is a rare but aggressive complication of rheumatoid arthritis (RA). The most common complications of RA occur in the severe and chronic stages of the disease. Only a few cases have been reported in the literature. The symptoms are usually non-specific, and arthralgia may be missing. Brain MRI and CSF analysis are useful to guide the diagnosis. However, a biopsy is required to demonstrate the existence of granulomatous lesions and the lack of mycobacterium infection. Early detection is essential to prevent neurological complications. Treatment consists of intravenous high doses of corticoid followed by oral tapered doses associated with immunosuppressive therapy. The present case is remarkable by the presence of granulomatous lesions in the lung and meninges and the dramatic improvement after immunosuppressive therapy. |
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arthralgia
asymptomatic
brain biopsy
CAT scan,chest
cerebrospinal fluid,abnormal
cerebrospinal fluid,elevated protein of
chest x-ray,abnormal
disorientation
fever
gait disorder
granulomatous disease
headache
immunosuppressive agents
lung biopsy
lymphadenopathy,hilar
meningeal enhancement
meningitis,granulomatous
meningitis,rheumatoid
meningoencephalitis
mental status,abnormal
MRI,abnormal
MRI,contrast enhanced
MRI,diffusion weighted
multinucleated giant cell
necrotizing granuloma
pleocytosis of cerebrospinal fluid
psychomotor retardation
pulmonary nodules
rheumatoid arthritis
rheumatoid arthritis factor(R.A.factor)
rheumatoid arthritis,neurologic complications of
steroid therapy,CNS treatment and complications with
treatment of neurologic disorder
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