J Korean Neurol Assoc.
2014 Feb;32(1):38-41.
Asymptomatic Rheumatoid Meningoencephalitis Presented After Discontinuation of Methotrexate
- Affiliations
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- 1Department of Neurology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea. skkim.stroke@gmail.com
Abstract
- Rheumatoid meningoencephalitis is a rare, but severe complication of rheumatoid arthritis (RA). A 64-year-old woman with the history of RA presented with abnormal behaviors and memory impairments since stopping methotrexate due to asymptomatic meningitis before 1 month. Brain MRI still demonstrated leptomeningeal enhancement in right fronto-temporal area, compared with the previous. Brain biopsy revealed multiple yellowish suppurative streaks in dura, and microscopically lymphoplasmic infiltrations and fibroid necrosis surrounded by granuloma. Soon after beginning treatment with corticosteroid and methotrexate, her symptoms improved.
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