2022
DOI: 10.3389/fimmu.2022.971934
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Case Report: Rheumatoid meningitis with positive NMDAR antibody: A case treated with intravenous immunoglobulin

Abstract: As a rare complication of rheumatoid arthritis (RA) in the central nervous system (CNS), rheumatoid meningitis (RM) mainly affects the meninges and has various clinical symptoms. The diagnostic and treatment approaches currently used are not practical. RM cases with positive NMDAR antibodies (Abs) have never been reported. In the present study, a 66-year-old man with a 1-year history of RA presented recurrent left lower limb weakness during activities for 1 month. The results showed that rheumatoid factor (RF)… Show more

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Cited by 4 publications
(6 citation statements)
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“… 23 As discussed in the above reports, 19 , 20 , 21 co‐exiting NMDAR antibodies should also be considered in infectious and autoimmune inflammatory pathologies of the CNS if the disease course is not monophasic, if the response to standard therapy is insufficient, or if atypical symptoms such as involuntary movements or psychiatric symptoms are also present. Although there are limited reports of the efficacy of IVIG in RM, 2 the present results suggest that IVIG may be effective in patients with RM with positive NMDAR antibodies. However, there have been limited case reports to date, and further cases and research on the frequency of NMDAR antibodies positivity in RM, pathological links, clinical course, and treatment methods are warranted.…”
Section: Discussionmentioning
confidence: 45%
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“… 23 As discussed in the above reports, 19 , 20 , 21 co‐exiting NMDAR antibodies should also be considered in infectious and autoimmune inflammatory pathologies of the CNS if the disease course is not monophasic, if the response to standard therapy is insufficient, or if atypical symptoms such as involuntary movements or psychiatric symptoms are also present. Although there are limited reports of the efficacy of IVIG in RM, 2 the present results suggest that IVIG may be effective in patients with RM with positive NMDAR antibodies. However, there have been limited case reports to date, and further cases and research on the frequency of NMDAR antibodies positivity in RM, pathological links, clinical course, and treatment methods are warranted.…”
Section: Discussionmentioning
confidence: 45%
“… 19 There is only one case of RM reported to date in which NMDAR antibodies in the CSF were positive. 2 However, in the previous report, the only symptom was paroxysmal weakness of the lower limbs, so the diagnostic criteria for anti‐NMDAR encephalitis were not met. In addition, NMDAR antibodies in the CSF were weakly positive (titer 1:1), suggesting that the involvement of NMDAR antibodies in the pathogenesis of the disease is uncertain.…”
Section: Discussionmentioning
confidence: 89%
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