Rheumatoid Meningitis: A Localized Immune Process

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Abstract
Rheumatoid pachymeningitis is a rare complication of rheumatoid arthritis. This disease was confined to the dura and pia-arachnoid of the lumbar cord in the patient. Her neurologic deficits responded to surgical decompression and corticosteroid therapy. Radiologic evidence and the differences in cell count, protein and glucose content between lumbar and cisternal CSF indicated that rheumatoid pachymeningitis can be localized to a discrete region of the CNS. Elevated immunoglobulins [Ig], IgM and IgG rheumatoid factors, low MW IgM and immune complexes were found in the CSF and implicated an immune reaction in the pathogenesis of this disease, which is probably similar to inflammatory processes involving other organs in rheumatoid arthritis.