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KMID : 0359720140320010038
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Journal of the Korean Neurological Association
2014 Volume.32 No. 1 p.38 ~ p.41
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Asymptomatic Rheumatoid Meningoencephalitis Presented After Discontinuation of Methotrexate
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Lee Gun-Ho
Son Seung-Nam
Kang Hee-Young
Park Ki-Jong
Choi Nack-Cheon
Lim Byeong-Hoon
Kwon Oh-Young
Kim Soo-Kyoung
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Abstract
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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.
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KEYWORD
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Meningoencephalitis, Rheumatoid arthritis, Methotrexate
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