Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct;41(10):1845-1853.
doi: 10.1007/s00296-021-04822-6. Epub 2021 Mar 9.

Aseptic meningitis in rheumatoid arthritis after anti-TNF administration: a case-based literature review

Reşit Yıldırım  1 , Döndü Üsküdar Cansu  2 , Deniz Arık  3 , Suzan Saylısoy  4 , Cengiz Korkmaz  2
Affiliations
Review

Aseptic meningitis in rheumatoid arthritis after anti-TNF administration: a case-based literature review

Reşit Yıldırım et al. Rheumatol Int. 2021 Oct.

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by articular and extra-articular manifestations. Among extra-articular involvement, rheumatoid meningitis (RM) is a rare condition, which may exhibit variable symptoms including headache, focal and/or generalized neurologic deficits. It may develop as the preceding manifestation of RA or occur at any time of the disease course. Some drugs used for the treatment of RA may give rise to aseptic meningitis or create a tendency to infectious meningitis due to their immunosuppressive effect. All these possibilities may lead to difficulties in the differential diagnosis. Achieving a diagnosis in a short time is crucial in terms of prognosis. Here, we would like to report a case with longstanding RA manifested by left-sided weakness and seizure shortly after initiating etanercept (ETA) therapy. ETA-induced meningitis was confirmed with appropriate diagnostic tools. Our aim with this case-based review is to attract the attention of this rare condition and discuss diagnostic challenges.

Keywords: Anti-tumor necrosis factor; Aseptic meningitis; Leptomeningitis; Meningitis; Pachymeningitis; Rheumatoid arthritis.

PubMed Disclaimer

References

    1. Sparks JA (2019) Rheumatoid arthritis. Ann Intern Med 170(1):ITC1–ITC16 - DOI
    1. Parsons AM, Aslam F, Grill MF, Aksamit AJ, Goodman BP (2020) Rheumatoid meningitis: clinical characteristics, diagnostic evaluation, and treatment. Neurohospitalist 10(2):88–94 - DOI
    1. Atzeni F, Talotta R, Masala IF, Gerardi MC, Casale R, Sarzi-Puttini P (2018) Central nervous system involvement in rheumatoid arthritis patients and the potential implications of using biological agents. Best Pract Res ClinRheumatol 32(4):500–510 - DOI
    1. Tsuzaki K, Nakamura T, Okumura H, Tachibana N, Hamano T (2017) Rheumatoid meningitis occurring during etanercept treatment. Case Rep Neurol Med. https://doi.org/10.1155/2017/7638539 - DOI
    1. Ahmed M, Luggen M, Herman JH, Weiss KL, Decourten-Myers G, Quinlan JG, Khanna D (2006) Hypertrophic pachymeningitis in rheumatoid arthritis after adalimumab administration. J Rheumatol 33(11):2344–2346

MeSH terms

Substances

LinkOut - more resources