Spinal rheumatoid meningitis: Clinicopathological Insights of rheumatoid nodule beyond the joint (Eng)
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Abstract
Rheumatoid meningitis (RM) is a rare extra-articular manifestation of rheumatoid arthritis (RA), characterized by pachymeningitis and/or leptomeningitis. Cranial RM were more common, while spinal involvement is very rare, particularly in seronegative RA. We described a 56-year-old Thai woman with seronegative RA who presented with acute bilateral leg weakness, gait instability, and urinary retention. MRI revealed circumferential spinal dural thickening and enhancement, consistent with hypertrophic pachymeningitis and leptomeningitis. Histopathology confirmed a rheumatoid nodule with mixed inflammatory patterns. Corticosteroid therapy led to complete clinical and radiological resolution. This case highlights an unusual presentation of spinal pachymeningitis as a neurological manifestation of seronegative RA, which may mimic other meningitides. RM should be considered in RA patients with unexplained myelopathy, regardless of serostatus, as early diagnosis and prompt immunosuppression can result in excellent outcomes.
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(ใส่ข้อความเดียวกันกับ ก๊อปปี้ไลน์ก็ได้)ดูตัวอย่างได้ที่หน้าบทความ---บทความนี้ตีพิมพ์เป็นลิขสิทธื์ของใคร...
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