Asymptomatic Rheumatoid Meningoencephalitis Presented After
Discontinuation of Methotrexate

J Korean Neurol Assoc > Volume 32(1); 2014 > Article

Journal of the Korean Neurological Association 2014;32(1): 38-41.

메토트렉세이트 중단 이후 발생한 무증상-류마티스수막염

이건호, 손승남 강희영 박기종 최낙천 임병훈 권오영 김수경

경상대학교 의학전문대원 신경과학교실, 건강과학연구원

Asymptomatic Rheumatoid Meningoencephalitis Presented After Discontinuation of Methotrexate

Gun-Ho Lee

Department of Neurology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea

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. Key Words: Meningoencephalitis, Rheumatoid arthritis, Methotrexate