{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:34:03Z","timestamp":1761824043036,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2018,7,14]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Leptomeningitis is a rare central nervous system manifestation of rheumatoid arthritis, generally in patients with established chronic rheumatoid disease. We report a 41-year-old man without previous rheumatoid arthritis or psychiatric disorder who presented with an acute neuropsychiatric disturbance and polyarthralgia. His MR scan of brain showed asymmetric bifrontal leptomeningitis, confirmed on (18F)-fluoro-D-glucose-positron emission tomography. Other investigations showed highly positive serum and cerebrospinal fluid anti-cyclic citrullinated peptide. A leptomeningeal biopsy showed necrotising leptomeningeal inflammation with ill-defined granulomas and lymphoplasmacytic infiltrate without organisms. Prolonged high-dose corticosteroids and then rituximab resulted in recovery. Chronic leptomeningitis can present with an acute neuropsychiatric disorder. We highlight that early rheumatoid disease can, rarely, cause a chronic leptomeningitis, reversible with immunotherapy.<\/jats:p>","DOI":"10.1136\/practneurol-2018-001978","type":"journal-article","created":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T12:14:42Z","timestamp":1533903282000},"page":"68-71","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Rheumatoid leptomeningitis presenting with an acute neuropsychiatric disorder"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-9293","authenticated-orcid":false,"given":"Michal","family":"Lubomski","sequence":"first","affiliation":[{"name":"Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Sy","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Buckland","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"Discipline of Pathology, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andie S","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethan","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of 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