Efficacy of Rituximab on Rheumatoid Leptomeningitis as the First Symptom of Rheumatoid Arthritis.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized mainly by arthritis, with the possible occurrence of extra-articular manifestations. We report the case of a patient who developed leptomeningitis as the first sign of RA, one year before the diagnosis of RA. Methylprednisolone 1000 mg was given intravenously. Because of the onset of seizures and cognitive impairment, rituximab was started. After three cycles of rituximab (1000 mg on day 0 and 1000 mg on day 15, every 6 months), neurological clinical examination, MRI and electroencephalogram findings were significantly improved.

LEARNING POINTS:

Rheumatoid meningitis may occur in the disease course of rheumatoid arthritis with varied and non-specific symptoms.Cerebrospinal fluid examination, MRI and tests for rheumatoid factor or anti-citrullinated protein antibodies in serum or in cerebrospinal fluid are key examinations for diagnosing rheumatoid meningitis.Rituximab has good efficacy in rheumatoid meningitis.

• Authors: Mickaël Chouk, Alexandre Halb, Christine Mekhail, Amélie Godot, Frank Verhoeven, Clément Prati, Daniel Wendling
• Journal: European journal of case reports in internal medicine (Eur J Case Rep Intern Med) Vol. 8 Issue 4 Pg. 002358 ( 2021) ISSN: 2284-2594 [Electronic] Italy
• PMID: 33987117 (Publication Type: Journal Article)
• Copyright: © EFIM 2021.