{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:16:46Z","timestamp":1740179806907,"version":"3.37.3"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T00:00:00Z","timestamp":1652227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Here, we report a case of central nervous system vasculitis in rheumatoid arthritis (RA) treated successfully with corticosteroid and mycophenolate. A 53-year-old female with poorly controlled RA presented with unilateral lower motor neurone type seventh cranial nerve palsy. Magnetic resonance imaging (MRI) of the brain revealed bilateral signal intensity changes in posterior fossa, basal ganglia, and periventricular white matter with contrast enhancement. Rheumatoid factor, anti-cyclic citrullinated peptides, and C-reactive protein were high. Cerebrospinal fluid analysis showed pleocytosis with elevated protein. Digital subtraction angiography of the brain revealed a beading pattern in distal branches of anterior, middle, and posterior cerebral arteries bilaterally suggestive of central nervous system vasculitis. We treated the patient with intravenous methylprednisolone followed by oral prednisolone tapered off in 6\u2009months. Mycophenolate mofetil was started at the dose of 2\u2009g per day, along with prednisolone. Sulfasalazine and hydroxychloroquine were also started to treat her arthritis. The patient showed complete neurological improvement, along with a significant resolution of the lesions in MRI.<\/jats:p>","DOI":"10.1093\/mrcr\/rxac042","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T01:26:32Z","timestamp":1652232392000},"page":"130-133","source":"Crossref","is-referenced-by-count":2,"title":["A case of central nervous system vasculitis secondary to rheumatoid arthritis treated successfully with mycophenolate"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7307-5749","authenticated-orcid":false,"given":"Shyamashis","family":"Das","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Institute of Neurosciences Kolkata , Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debanjali","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Institute of Neurosciences Kolkata , Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirban","family":"Ghosal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurosciences Kolkata , Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukalyan","family":"Purkayastha","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuro-Radiology, Institute of Neurosciences Kolkata , Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2023010315521814000_R1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/acr.20689","article-title":"Investigators of the Autoimmunity Rituximab Registry. Rituximab therapy for systemic vasculitis associated with rheumatoid arthritis: results from the AutoImmunity and Rituximab Registry","volume":"64","author":"Pu\u00e9chal","year":"2012","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2023010315521814000_R2","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.jbspin.2010.02.030","article-title":"Isolated cerebral vasculitis associated with rheumatoid arthritis","volume":"77","author":"Caballol Pons","year":"2010","journal-title":"Joint Bone Spine"},{"key":"2023010315521814000_R3","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.berh.2019.02.003","article-title":"Central nervous system involvement in rheumatoid arthritis patients and the potential implications of using biological agents","volume":"32","author":"Atzeni","year":"2018","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2023010315521814000_R4","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1093\/qjmed\/hcs083","article-title":"Cerebral vasculitis in rheumatoid arthritis","volume":"107","author":"Spath","year":"2014","journal-title":"Qjm"},{"key":"2023010315521814000_R5","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1136\/practneurol-2015-001306","article-title":"Rheumatoid meningitis","volume":"16","author":"Nihat","year":"2016","journal-title":"Pract Neurol"},{"key":"2023010315521814000_R6","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1001\/jamaneurol.2015.1105","article-title":"Rheumatoid meningitis presenting with multiple strokelike episodes","volume":"72","author":"Roy","year":"2015","journal-title":"JAMA Neurol"},{"key":"2023010315521814000_R7","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1552-6569.2005.tb00325.x","article-title":"An unusual presentation of rheumatoid meningitis","volume":"15","author":"Chowdhry","year":"2005","journal-title":"J Neuroimaging"},{"key":"2023010315521814000_R8","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1136\/ard.2005.042093","article-title":"Successful treatment of rheumatoid meningitis with cyclophosphamide but not infliximab","volume":"65","author":"Chou","year":"2006","journal-title":"Ann Rheum Dis"},{"key":"2023010315521814000_R9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.semarthrit.2015.02.008","article-title":"Mycophenolate mofetil in primary central nervous system vasculitis","volume":"45","author":"Salvarani","year":"2015","journal-title":"Semin Arthritis Rheum"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxac042\/43866965\/rxac042.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/7\/1\/130\/48482368\/rxac042.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/7\/1\/130\/48482368\/rxac042.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T15:55:23Z","timestamp":1672761323000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/7\/1\/130\/6583467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,11]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,5,11]]},"published-print":{"date-parts":[[2023,1,3]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxac042","relation":{},"ISSN":["2472-5625"],"issn-type":[{"type":"electronic","value":"2472-5625"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,5,11]]}}}