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• Vol.60 No.9
• CLINICA NEUROL, 60: 631−635, 2020
• Vol.60 No.9 contents

Case Report

Elevation of cerebrospinal fluid anti-cyclic citrullinated peptides antibody index is useful for rheumatoid meningitis preceding neurological symptoms without arthritis: a case report

Minako Yamaoka, M.D.¹⁾, Tesseki Izumi, M.D., Ph.D.¹⁾, Nobuyuki Eura, M.D.¹⁾, Ryota Sasaki, M.D.²⁾, Takao Kiriyama, M.D., Ph.D.¹⁾ and Kazuma Sugie, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, Nara Medical University
²⁾ Department of Neurosurgery, Nara Medical Center

We report a 62-year-old female with rheumatoid meningitis. She presented with mental disorder, loss of consciousness, generalized seizures, and cognitive impairment. Brain MRI demonstrated high intensity lesions and abnormal enhancement along the left frontal and parietal sulci. Her serum and cerebrospinal fluid were positive for anticyclic citrullinated peptides (CCP) antibody, and the antibody index of cerebrospinal fluid anti-CCP antibody increased, which led us to suspect rheumatoid meningitis. Her symptoms improved immediately by methylpredonisolone pulse therapy and anti-CCP antibody turned negative in cerebrospinal fluid. However, she revealed arthritis with the reduction of betamethasone and was diagnosed as rheumatoid arthritis. We suggest that the elevation of antibody index of cerebrospinal fluid anti-CCP antibody is useful in the diagnosis of rheumatoid meningitis preceding neurological symptoms without arthritis, and anti-CCP antibody in cerebrospinal fluid may be helpful as the evaluation of the treatment.
Full Text of this Article in Japanese PDF (1284K)

(CLINICA NEUROL, 60: 631−635, 2020)
key words: Rheumatoid meningitis, antibody index of cerebrospinal fluid anti-cyclic citrullinated peptides antibody, anticyclic citrullinated peptides antibody

(Received: 30-Mar-20)