Anti-cyclic citrullinated peptide antibody in the cerebrospinal fluid in patients with rheumatoid arthritis who have central nervous system involvement

Misako Higashida-Konishi, Keisuke Izumi, Masako Tsukamoto, Hiroaki Ohya, Nozomi Takasugi, Satoshi Hama, Yutaro Hayashi, Mari Ushikubo, Kumiko Akiya, Araki Kazuhiro, Yutaka Okano, Hisaji Oshima

研究成果: Review article査読

1 被引用数 (Scopus)

抄録

Central nervous system (CNS) involvement, including encephalopathy, encephalitis, leptomeningitis, and pachymeningitis, in rheumatoid arthritis (RA) is rather rare. We report the case of a 61-year-old female with a history of RA in remission for 7 years, who presented with numbness, weakness of the left upper limb, dysarthria, and headache. Magnetic resonance imaging (MRI) of the brain showed meningeal enhancement in the frontal, parietal, and temporal lobes. Cerebrospinal fluid (CSF) examination detected high levels of both rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA), with a high ACPA-immunoglobulin G index (> 2.0). She was diagnosed with rheumatoid meningitis. Following combined therapy with oral prednisolone and intravenous infusion of cyclophosphamide, her symptoms promptly improved. After treatment, RF and ACPA levels in the CSF were reduced, and MRI showed improvement of the meningeal structures. This case, along with existing literature, suggests that the ACPA level in the CSF may serve as a useful marker for diagnosing of CNS involvement in RA, as well as an index of effectiveness of the associated treatment.

本文言語English
ページ(範囲)2441-2448
ページ数8
ジャーナルClinical Rheumatology
39
8
DOI
出版ステータスPublished - 2020 8月 1
外部発表はい

ASJC Scopus subject areas

  • リウマチ学

フィンガープリント

「Anti-cyclic citrullinated peptide antibody in the cerebrospinal fluid in patients with rheumatoid arthritis who have central nervous system involvement」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル