메토트렉세이트 중단 이후 발생한무증상-류마티스수막염

Abstract

Rheumatoid meningoencephalitis is a rare, but severe complication of rheumatoid arthritis (RA). A 64-year-old womanwith the history of RA presented with abnormal behaviors and memory impairments since stopping methotrexate due asymptomatic meningitis before 1 month. Brain MRI still demonstrated leptomeningeal enhancement in rightfronto-temporal area, compared with the previous. Brain biopsy revealed multiple yellowish suppurative streaks dura, and microscopically lymphoplasmic infiltrations and fibroid necrosis surrounded by granuloma. Soon afterbeginning treatment with corticosteroid and methotrexate, her symptoms improved.