{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:38:57Z","timestamp":1770223137242,"version":"3.49.0"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,11,9]]},"abstract":"<jats:p>The overall incidence of neurological manifestations is relatively low among patients with mixed connective tissue disease (MCTD). We recently encountered a case of autoimmune adhesive arachnoiditis in a young woman with 7\u2005years history of MCTD who presented with severe back pain and myeloradiculopathic symptoms of lower limbs. To the best of our knowledge, adhesive arachnoiditis in an MCTD patient has never been previously reported. We report here this rare case, with the clinical picture and supportive ancillary data, including serology, cerebral spinal fluid analysis, electrophysiological evaluation and spinal neuroimaging, that is, MRI and CT (CT scan) of thoracic and lumbar spine. Her neurological deficit improved after augmenting her immunosuppressant therapy. Our case suggests that adhesive arachnoiditis can contribute to significant neurological deficits in MCTD and therefore requires ongoing surveillance.<\/jats:p>","DOI":"10.1136\/bcr-2016-217418","type":"journal-article","created":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T13:37:02Z","timestamp":1482586622000},"page":"bcr2016217418","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Adhesive arachnoiditis in mixed connective tissue disease: a rare neurological manifestation"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-4670","authenticated-orcid":false,"given":"Maria Usman","family":"Khan","sequence":"first","affiliation":[{"name":"Rheumatology Department, University Hospital Limerick, Limerick, Ireland"},{"name":"Graduate entry medical school, University of Limerick, Limerick, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Anthony Joseph","family":"Devlin","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University Hospital Limerick, Limerick, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Fraser","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University Hospital Limerick, Limerick, Ireland"},{"name":"Graduate entry medical school, University of Limerick, Limerick, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,12,16]]},"reference":[{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/33.12.1117"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780210818"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.3","first-page":"171","article-title":"Topical review-connective tissue diseases: orofacial manifestations including pain","volume":"21","author":"Klasser","year":"2007","journal-title":"J Orofac Pain"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.4","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/01.rhu.0000222045.70861.a5","article-title":"Trigeminal neuralgia as the first manifestation of mixed connective tissue disorder","volume":"12","author":"Hojaili","year":"2006","journal-title":"J Clin Rheumatol"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(78)90747-7"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.6","doi-asserted-by":"publisher","DOI":"10.1177\/000331979404501110"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.7","doi-asserted-by":"publisher","DOI":"10.1177\/088307389300800309"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.8","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s10067-005-0158-1","article-title":"Transverse myelitis, a rare neurological manifestation of mixed connective tissue disease\u2013a case report and a review of literature","volume":"26","author":"Bhinder","year":"2007","journal-title":"Clin Rheumatol"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.9","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.4.532"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.10","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s10792-006-9015-8","article-title":"Retinal vasculitis and vitreous hemorrhage associated with mixed connective tissue disease: retinal vasculitis in MCTD","volume":"26","author":"Mimura","year":"2005","journal-title":"Int Ophthalmol"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.11","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199004000-00011"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.12","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.5.1025"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.13","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(72)90064-2"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.14","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh009"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.15","first-page":"59","article-title":"[Adhesive lumbar arachnoiditis]","volume":"2013","author":"Ribeiro","year":"1998","journal-title":"Acta Med Port"},{"key":"2025082800380887000_2016.dec16_1.bcr2016217418.16","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jbspin.2004.03.013","article-title":"Post-lumbar puncture arachnoiditis. 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