{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:42:32Z","timestamp":1792233752366,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":289,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Neurological Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Mixed connective tissue disease (MCTD) may rarely involve the central nervous system (CNS), and CNS vasculitis can present with acute seizures, altered consciousness, and focal neurological deficits. We report a 27\u2010year\u2010old woman with a seven\u2010year history of arthralgia, morning stiffness, intermittent fever, and malaise who developed acute seizures, altered sensorium, and hemiparesis approximately two weeks before hospital admission. Laboratory evaluation demonstrated severe anemia, thrombocytopenia, elevated inflammatory markers, and positive anti\u2010U1 ribonucleoprotein (U1\u2010RNP) antibodies. Cerebrospinal fluid (CSF) showed lymphocyte\u2010predominant pleocytosis and markedly elevated protein, while brain MRI demonstrated multifocal confluent subcortical and periventricular lesions with restricted diffusion. Based on clinical, serological, CSF, and neuroimaging findings, MCTD\u2010associated CNS vasculitis was considered probable. The patient received broad\u2010spectrum antibiotics and antiseizure and antihypertensive therapy, followed by methylprednisolone pulses, oral prednisolone, and hydroxychloroquine, with significant neurological improvement at discharge. Cyclophosphamide therapy was planned; however, no subsequent follow\u2010up data were available. This case emphasizes the need to consider CNS involvement in patients with MCTD while recognizing the limitations of imaging specificity and incomplete long\u2010term follow\u2010up.<\/jats:p>","DOI":"10.1155\/crnm\/1782813","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:53:47Z","timestamp":1792230827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mixed Connective Tissue Disease (MCTD): A Rare Presentation of Probable Central Nervous System (CNS) Vasculitis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9041-194X","authenticated-orcid":false,"given":"Arpan","family":"Mitra","sequence":"first","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5369-4195","authenticated-orcid":false,"given":"Niraj Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-5018","authenticated-orcid":false,"given":"Ankur","family":"Vivek","sequence":"additional","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0579-6489","authenticated-orcid":false,"given":"Nayana","family":"Bhuyan","sequence":"additional","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2210-194X","authenticated-orcid":false,"given":"Rukhsar","family":"Parveen","sequence":"additional","affiliation":[{"name":"Department of Kaya Chikitsa, Faculty of Ayurveda Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-7956","authenticated-orcid":false,"given":"Vijaya Nath","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5975-1699","authenticated-orcid":false,"given":"Abhishek","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Neurology Institute of Medical Sciences (IMS) Banaras Hindu University (BHU)  Varanasi 221005 Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(72)90064-2"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew265"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.008"},{"key":"e_1_2_12_4_2","first-page":"259","article-title":"Japanese Diagnostic Criteria for Mixed Connective Tissue Disease in Caucasian Patients","volume":"19","author":"Doria A.","year":"1992","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_12_5_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/14397595.2019.1709944","article-title":"Diagnostic Criteria for Mixed Connective Tissue Disease (MCTD): From the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Systemic Autoimmune Diseases","volume":"31","author":"Tanaka Y.","year":"2019","journal-title":"Modern Rheumatology"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2007.10.002"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0733-8619(03)00057-4"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/495201"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200406000-00014"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/bor.0b013e32831cf5e6"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2008.09.015"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2005.11.009"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/08916930400022715"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2006.08.007"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2012.01.009"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000011360"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/25785826.2024.2338593"},{"key":"e_1_2_12_18_2","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/1529-0131(199905)42:5<899::AID-ANR8>3.0.CO;2-L","article-title":"Long-Term Outcome in Mixed Connective Tissue Disease: Longitudinal Clinical and Serologic Findings","volume":"42","author":"Burdt M. A.","year":"1999","journal-title":"Arthritis & Rheumatism"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2005.04.004"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.24716"},{"key":"e_1_2_12_21_2","first-page":"288","article-title":"Mixed Connective Tissue Disease","volume":"132","author":"Prystowsky S. D.","year":"1980","journal-title":"Western Journal of Medicine"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1978.tb06121.x"}],"container-title":["Case Reports in Neurological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crnm\/1782813","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crnm\/1782813","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crnm\/1782813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:53:49Z","timestamp":1792230829000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crnm\/1782813"}},"subtitle":[],"editor":[{"given":"Semonti","family":"Nandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crnm\/1782813"],"URL":"https:\/\/doi.org\/10.1155\/crnm\/1782813","archive":["Portico"],"relation":{},"ISSN":["2090-6668","2090-6676"],"issn-type":[{"value":"2090-6668","type":"print"},{"value":"2090-6676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1782813"}}