Induction of complete and sustained remission of rheumatoid pachymeningitis by rituximab
Open Access
- 28 May 2009
- journal article
- case report
- Published by Wiley in Arthritis & Rheumatism
- Vol. 60 (6), 1632-1634
- https://doi.org/10.1002/art.24577
Abstract
Aseptic pachymeningitis is a rare and serious complication of rheumatoid arthritis (RA). Herein, we describe a patient with rheumatoid factor–positive and anti–cyclic citrullinated peptide–positive RA who experienced a focal seizure, with aphasia and convulsions of the right side of the body. The findings of magnetic resonance imaging and histologic analysis led to a diagnosis of rheumatoid pachymeningitis. Because the patient had a large number of CD20‐expressing B lymphocytes, therapy with rituximab was started and has resulted in complete and sustained remission of both the pachymeningitis and the RA for >2 years. Despite a decrease in immunoglobulins, the patient has remained free of infections, which illustrates the favorable outcome that can result from therapeutic B cell depletion in this potentially lethal manifestation of RA.Keywords
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