Recurrent aseptic meningitis- a rare clinical presentation of Sjogrens syndrome

Basheer, Asma; Khan, Ejaz Ahmed; Hashmi, Tahir; Khan, Rashid Ali; Ahmad, Arsalan

doi:10.5455/jpma.295727

Cited by 3 publications

(7 citation statements)

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“…The acute presentation is characterized by several meningitis features, including headache, neck stiffness, and rarely, focal neurological findings and seizure [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…The cerebrospinal fluid (CSF) can show variable pleocytosis, consisting mainly of polymorphonuclear leukocytes at the beginning, followed by mononuclear cells. Oligoclonal bands of immunoglobulins in the CSF have also been described [ 26 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…CT and magnetic resonance imaging (MRI) may be normal or show non-disease-specific findings, such as diffuse leptomeningeal and subarachnoid enhancement [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Cyclophosphamide, azathioprine, cyclosporine, methotrexate, chlorambucil, and tacrolimus, alone or in association with corticosteroids, may also be useful. Recently, anti-CD20 monoclonal antibody (rituximab) has been reported to successfully treat CNS manifestation of SS [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

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Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Leuci¹,

Coppola²,

Cantile³

et al. 2022

IJERPH

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Aseptic meningitis (AM) is a potentially severe and life-threatening disease characterized by meningeal inflammation, usually with mononuclear pleocytosis. It represents a challenging and controversial issue in medicine for multiple etiologies, classification, and difficult diagnosis in the face of nonspecific sets of signs and symptoms. In the area of interest of oral medicine, in specific clusters of patients, even if rare, the occurrence of aseptic meningitis can pose a diagnostic and management dilemma in the following potential etiologies: (i) systemic diseases with oral and meningeal involvement, which include Behçet’s disease and Sjögren syndrome; (ii) drug-induced aseptic meningitis; (iii) aseptic viral meningitis, mostly related to herpes simplex virus infection and hand, foot, and mouth disease, caused by enteroviruses. In this review, clinical manifestations, diagnostic methodologies, incidence, treatment, and prognosis for each of these clinical entities are provided. Furthermore, two illustrative case reports are described: a patient suffering from recurrent oral ulcers, in which a sudden onset of AM allows us to diagnose Neuro Behçet’s disease, and a patient affected by pemphigus vulgaris, manifesting a drug-induced AM. Exploring this complex clinical entity scenario, it is clear that an oral medicine specialist has a place on any multidisciplinary team in making such a challenging diagnosis.

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“…The acute presentation is characterized by several meningitis features, including headache, neck stiffness, and rarely, focal neurological findings and seizure [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…CT and magnetic resonance imaging (MRI) may be normal or show non-disease-specific findings, such as diffuse leptomeningeal and subarachnoid enhancement [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Leuci¹,

Coppola²,

Cantile³

et al. 2022

IJERPH

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“…Jogren) uma doença reumatológica que geralmente se apresenta com olhos secos, boca seca, dor nas articulações e fadiga (BASHEER, A. et al 2019) entre outras.…”

Section: Introductionunclassified

Avaliação da saúde bucal dos pacientes assistidos no ambulatório de reumatologia do Hospital Universitário da Universidade Federal de Juiz de Fora

Ferreira¹

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As doenças reumatológicas abrange um grupo variado de patologias que têm como característica comum o acometimento das articulações e do sistema musculoesquelético. Podendo apresentar manifestações clínicas variadas. Geralmente, aparecem de forma insidiosa, mostrando sinais e sintomas na cavidade oral em seus estágios iniciais. O objetivo do presente estudo foi avaliar, através de protocolo odontológico, a condição bucal de pacientes assistidos no Setor de Reumatologia do Hospital Universitário da Universidade Federal de Juiz de Fora (HU- UFJF). Para isso foram utilizados uma ficha clínica, índice CPO-D, questionário de xerostomia, dosagem de fluxo salivar e questionário de perfil de impacto de saúde bucal (OHIP-14). Foram incluídos 21 pacientes, dentre os quais, 10 com diagnóstico de LES, 1 com Chikungunya, 1 com diagnóstico de DMTC, 3 com AR, 1 diagnosticado AIJ, 4 com ES e 1 com diagnóstico de S. Jogren. Sendo que, 16 (76,2%) eram do sexo feminino e 5 (23,8%) do sexo masculino. Todos os pacientes faziam uso de medicações para controle e tratamento da doença. A média do índice de CPO-D foi de 21,52. E a análise do fluxo salivar revelou que 9 dos pacientes (42,86%) apresentavam redução do fluxo salivar e 1 (10%) -LES- hipossalivação sem estimulo e enquanto que 3 (14,29%) apresentam redução do fluxo e 9 (42,86%) hipossalivação quando estimulado, sendo que 18 (85,71%) relataram sintomas de xerostomia. Dos 21 pacientes avaliados apenas 1 (4,76%) teve um maior comprometimento da qualidade de vida geral relacionado a saúde bucal, uma vez que, pontuou acima de 14 pontos (metade da pontuação do questionário OHIP-14). Pode-se concluir que pacientes com doenças reumatológicas apresentam alto índice de CPO-D, redução do fluxo salivar (xerostomia e hipossalivação) e pouca interferência dessas condições em sua saúde geral. Estes dados incrementados poderão contribuir para prevenção e uma intervenção terapêutica mais eficaz das doenças bucais em pacientes reumáticos e podem auxiliar na melhor compreensão do início da doença e a redução de suas comorbidades.

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Aseptic Meningitis as an Initial Presentation of Primary Sjögren's Syndrome: A Case Report

Alnajjar,

Alfuwayris,

Al Arfaj

et al. 2024

Cureus

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Neurological symptoms that occur before the diagnosis of primary Sjögren's syndrome (PSS) can vary and affect either the central nervous system (CNS) or the peripheral nervous system (PNS). Aseptic meningitis, although rare, can be an initial central neurological sign of PSS. This case report describes a 54-year-old patient who was initially presented with aseptic meningitis and was subsequently diagnosed with PSS. The diagnosis was based on clinical features and the results of serum autoantibody tests. The patient did not undergo a minor salivary gland biopsy to confirm the diagnosis. Symptomatic management resulted in an improvement in the patient’s condition.

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Recurrent aseptic meningitis- a rare clinical presentation of Sjogrens syndrome

Cited by 3 publications

References 0 publications

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Avaliação da saúde bucal dos pacientes assistidos no ambulatório de reumatologia do Hospital Universitário da Universidade Federal de Juiz de Fora

Aseptic Meningitis as an Initial Presentation of Primary Sjögren's Syndrome: A Case Report

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