A case of rheumatoid meningitis with anti-cyclic citrullinated peptides antibody in cerebrospinal fluids accorded with the change of the clinical course

DOI Open Access
  • Matsuda Wataru
    Kansai medical university, First department of internal medicine
  • Ozaki Yoshio
    Kansai medical university, First department of internal medicine
  • Shigesaka Minoru
    Kansai medical university, First department of internal medicine
  • Ishii Nobuyasu
    Kansai medical university, First department of internal medicine
  • Tanaka Akihiro
    Kansai medical university, First department of internal medicine
  • Nishizawa Tohru
    Kansai medical university, First department of internal medicine
  • Amuro Hideki
    Kansai medical university, First department of internal medicine
  • Son Yonsu
    Kansai medical university, First department of internal medicine
  • Nomura Shosaku
    Kansai medical university, First department of internal medicine
  • Li Yi
    Kansai medical university, Department of Neurosurgery
  • Yoshimura Shinichi
    Kansai medical university, Department of Neurosurgery
  • Nakayama Kentaro
    Kansai medical university, Department of Neurology

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Other Title
  • 髄膜炎で発症し髄液中抗シトルリン化ペプチド抗体が臨床経過の推移と一致したリウマチ性髄膜炎の一例

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Abstract

<p>We report a 77-year-old man with rheumatoid meningitis. He came to the hospital because he had difficulty in walking and communication. His brain magnetic resonance imaging（MRI）showed increased fluid attenuated inversion recovery（FLAIR）signals in his right cerebral hemisphere cortex, and contrasting effects along the cerebral sulcus and surface were detected. Although he presented no joint symptoms, he was diagnosed with rheumatoid meningitis based on the positivity of RF and anti-CCP antibody in his cerebrospinal fluid and seurm, and the pathology of cerebral biopsy. After the initiation of corticosteroid therapy, the titer of anti-CCP antibody in his cerebrospinal fluids were decreased in accordance with the change of the clinical course. Anti-CCP antibody in the cerebrospinal fluids was a helpful biomarker in diagnosis and assessment of the severity of rheumatoid meningitis.</p>

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