{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:15:39Z","timestamp":1771049739857,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the 2021 Innovation and Entrepreneurship Project for Returned Overseas Researchers in Ningxia, China and the Foundation of Ningxia Medical University .","award":["grant number: 352. XM2022029."],"award-info":[{"award-number":["grant number: 352. XM2022029."]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rheumatoid meningitis (RM) is a rare extra-articular manifestation of rheumatoid arthritis (RA) that has been increasingly recognized by neurologists. However, the diversity of its clinical manifestations makes its diagnosis difficult. RM does not have a unified diagnostic standard, and its link with RA needs to be studied further. Here we report two cases of RM without a history of RA. The first patient, an 80-year-old woman, presented with sudden unilateral limb weakness, with brain MR showing abnormal signals in the leptomeningeal of the right frontal parietal. Subarachnoid hemorrhage was excluded after imaging examination, and infectious meningitis was ruled out after cerebrospinal fluid (CSF) examination. The patient was diagnosed as having RM, she had increased levels of CCP and AKA, the markers of RA, but no history of the disease or other clinical manifestations of it. Another case, a 65-year-old man, was hospitalized with Bell\u2019s palsy. We found that he had intracranial imaging changes highly consistent with those characteristic of RM during his routine examination. Except for the left peripheral facial palsy, the patient had no other neurological signs or symptoms and no RA history. After a careful physical examination, we found no joint or other manifestations or serological abnormalities consistent with RA (RF, CCP, AKA, etc.). However, after excluding infection meningitis and considering the patient\u2019s unique imaging results, we diagnosed him as having RM. We report these two cases as references for clinical diagnosis and treatment of RM, providing a discussion of our rationale.<\/jats:p>","DOI":"10.1186\/s12883-024-03751-8","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T08:09:57Z","timestamp":1721030997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Rheumatoid meningitis in the absence of rheumatoid arthritis: 2 cases"],"prefix":"10.1186","volume":"24","author":[{"given":"Juan","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boya","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"11","key":"3751_CR1","first-page":"1099","volume":"17","author":"R Ouyang","year":"1967","unstructured":"Ouyang R, Mitchell DM, Rozdilsky B. Central nervous system involvement in rheumatoid disease. Rep case [J] Neurol. 1967;17(11):1099\u2013105.","journal-title":"Rep case [J] Neurol"},{"issue":"3","key":"3751_CR2","first-page":"129","volume":"107","author":"RG Spurlock","year":"1983","unstructured":"Spurlock RG, Richman AV. Rheumatoid meningitis. A case report and review of the literature [J]. Arch Pathol Lab Med. 1983;107(3):129\u201331.","journal-title":"Arch Pathol Lab Med"},{"key":"3751_CR3","doi-asserted-by":"crossref","unstructured":"Mckenna MC, Vaughan D, Bermingham N et al. Rheumatoid arthritis presenting as rheumatoid meningitis [J]. BMJ case Rep, 2019, 12(1).","DOI":"10.1136\/bcr-2018-226649"},{"issue":"2","key":"3751_CR4","doi-asserted-by":"publisher","first-page":"295","DOI":"10.4067\/s0034-98872021000200295","volume":"149","author":"C Guevara","year":"2021","unstructured":"Guevara C, Villa E, N\u00fa\u00f1ez R, et al. Rheumatoid meningitis: report of two cases [J]. Rev Med Chil. 2021;149(2):295\u2013303.","journal-title":"Rev Med Chil"},{"issue":"3","key":"3751_CR5","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1111\/j.1552-6569.2005.tb00325.x","volume":"15","author":"V Chowdhry","year":"2005","unstructured":"Chowdhry V, Kumar N, Lachance DH, et al. An unusual presentation of rheumatoid meningitis [J]. J Neuroimaging: Official J Am Soc Neuroimaging. 2005;15(3):286\u20138.","journal-title":"J Neuroimaging: Official J Am Soc Neuroimaging"},{"key":"3751_CR6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.jneuroim.2018.12.001","volume":"328","author":"C Lee Ching","year":"2019","unstructured":"Lee Ching C, Kenyon L, Berk M, et al. Rheumatoid meningitis sine arthritis [J]. J Neuroimmunol. 2019;328:73\u20135.","journal-title":"J Neuroimmunol"},{"issue":"3","key":"3751_CR7","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/NRL.0b013e31821735ad","volume":"17","author":"MJ Aguilar-Amat","year":"2011","unstructured":"Aguilar-Amat MJ, Abenza-Abild\u00faa MJ, Vivancos F, et al. Rheumatoid meningitis mimicking progressive supranuclear palsy [J]. Neurologist. 2011;17(3):136\u201340.","journal-title":"Neurologist"},{"key":"3751_CR8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3389\/fneur.2019.00163","volume":"10","author":"D Pellerin","year":"2019","unstructured":"Pellerin D, Wodkowski M, Guiot MC, et al. Rheumatoid meningitis presenting with Acute parkinsonism and protracted non-convulsive seizures: an unusual case presentation and review of treatment strategies [J]. Front Neurol. 2019;10:163.","journal-title":"Front Neurol"},{"issue":"4","key":"3751_CR9","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.neurad.2013.10.005","volume":"41","author":"M Roques","year":"2014","unstructured":"Roques M, Tanchoux F, Calvi\u00e8re L, et al. MRI with DWI helps in depicting rheumatoid meningitis [J]. J Neuroradiol = J de Neuroradiologie. 2014;41(4):275\u20137.","journal-title":"J Neuroradiol = J de Neuroradiologie"},{"issue":"1","key":"3751_CR10","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.jocn.2009.01.033","volume":"17","author":"M Matsushima","year":"2010","unstructured":"Matsushima M, Yaguchi H, Niino M, et al. MRI and pathological findings of rheumatoid meningitis [J]. J Clin Neuroscience: Official J Neurosurgical Soc Australasia. 2010;17(1):129\u201332.","journal-title":"J Clin Neuroscience: Official J Neurosurgical Soc Australasia"},{"issue":"2","key":"3751_CR11","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.jocn.2014.07.031","volume":"22","author":"C Nesbitt","year":"2015","unstructured":"Nesbitt C, Willshire L, Quan D, et al. Leptomeningeal rheumatoid nodules: diagnosis and failed therapeutics [J]. J Clin Neuroscience: Official J Neurosurgical Soc Australasia. 2015;22(2):425\u20138.","journal-title":"J Clin Neuroscience: Official J Neurosurgical Soc Australasia"},{"issue":"2","key":"3751_CR12","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1111\/j.1552-6569.2008.00299.x","volume":"20","author":"A Cianfoni","year":"2010","unstructured":"Cianfoni A, Falcone C, Faustini F, et al. Rheumatoid leptomeningitis: magnetic resonance imaging and pathologic findings\u2013a case report [J]. J Neuroimaging: Official J Am Soc Neuroimaging. 2010;20(2):192\u20134.","journal-title":"J Neuroimaging: Official J Am Soc Neuroimaging"},{"issue":"17","key":"3751_CR13","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.2169\/internalmedicine.49.3492","volume":"49","author":"K Ikeda","year":"2010","unstructured":"Ikeda K, Takazawa T, Ito H, et al. Rheumatoid leptomeningitis: radiological alteration of cerebral hypoperfusion and subarachnoid lesions [J]. Intern Med (Tokyo Japan). 2010;49(17):1911\u20136.","journal-title":"Intern Med (Tokyo Japan)"},{"issue":"2","key":"3751_CR14","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1093\/mrcr\/rxad010","volume":"7","author":"M Aktan Suzgun","year":"2023","unstructured":"Aktan Suzgun M, Erener N, Cavus GH, et al. A review of rheumatoid meningitis with case studies [J]. Mod Rheumatol case Rep. 2023;7(2):340\u20136.","journal-title":"Mod Rheumatol case Rep"},{"issue":"9","key":"3751_CR15","doi-asserted-by":"publisher","first-page":"3201","DOI":"10.1111\/ene.14904","volume":"28","author":"E Villa","year":"2021","unstructured":"Villa E, Sarquis T, De Grazia J, et al. Rheumatoid meningitis: a systematic review and meta-analysis [J]. Eur J Neurol. 2021;28(9):3201\u201310.","journal-title":"Eur J Neurol"},{"issue":"6","key":"3751_CR16","first-page":"1247","volume":"11","author":"WT Yuh","year":"1990","unstructured":"Yuh WT, Drew JM, Rizzo M, et al. Evaluation of pachymeningitis by contrast-enhanced MR imaging in a patient with rheumatoid disease [J]. AJNR Am J Neuroradiol. 1990;11(6):1247\u20138.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"1","key":"3751_CR17","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1212\/CPJ.0000000000000678","volume":"10","author":"Z Qin","year":"2020","unstructured":"Qin Z, Kim J, Valencia D, et al. Rheumatoid meningitis: a case report and review of the literature [J]. Neurol Clin Pract. 2020;10(1):73\u201383.","journal-title":"Neurol Clin Pract"},{"issue":"2","key":"3751_CR18","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1177\/1941874419859769","volume":"10","author":"F PARSONS A M, ASLAM","year":"2020","unstructured":"PARSONS A M, ASLAM F, GRILL M F, et al. Rheumatoid meningitis: clinical characteristics, diagnostic evaluation, and treatment [J]. Neurohospitalist. 2020;10(2):88\u201394.","journal-title":"Neurohospitalist"},{"issue":"7","key":"3751_CR19","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1007\/s10067-019-04464-x","volume":"38","author":"XP Wang","year":"2019","unstructured":"Wang XP, Cheng QY, Gu MM, et al. Diagnostic accuracy of anti-keratin antibody for rheumatoid arthritis: a meta-analysis [J]. Clin Rheumatol. 2019;38(7):1841\u20139.","journal-title":"Clin Rheumatol"},{"issue":"5","key":"3751_CR20","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1093\/rheumatology\/keg184","volume":"42","author":"S Bas","year":"2003","unstructured":"Bas S, Genevay S, Meyer O, et al. Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis [J]. Rheumatology (Oxford). 2003;42(5):677\u201380.","journal-title":"Rheumatology (Oxford)"},{"issue":"10","key":"3751_CR21","doi-asserted-by":"publisher","first-page":"2741","DOI":"10.1002\/art.11223","volume":"48","author":"S Rantap\u00e4\u00e4-Dahlqvist","year":"2003","unstructured":"Rantap\u00e4\u00e4-Dahlqvist S, De Jong BA, Berglin E, et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis [J]. Arthritis Rheum. 2003;48(10):2741\u20139.","journal-title":"Arthritis Rheum"},{"issue":"4","key":"3751_CR22","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s00281-017-0627-z","volume":"39","author":"V Derksen","year":"2017","unstructured":"Derksen V, Huizinga TWJ, van der Woude D. The role of autoantibodies in the pathophysiology of rheumatoid arthritis [J]. Semin Immunopathol. 2017;39(4):437\u201346.","journal-title":"Semin Immunopathol"},{"issue":"4","key":"3751_CR23","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/0049-0172(89)90047-4","volume":"18","author":"JM Bathon","year":"1989","unstructured":"Bathon JM, Moreland LW, Dibartolomeo AG. Inflammatory central nervous system involvement in rheumatoid arthritis [J]. Semin Arthritis Rheum. 1989;18(4):258\u201366.","journal-title":"Semin Arthritis Rheum"},{"issue":"12","key":"3751_CR24","doi-asserted-by":"publisher","first-page":"3833","DOI":"10.1007\/s10067-020-05221-1","volume":"39","author":"M Rodriguez Alvarez","year":"2020","unstructured":"Rodriguez Alvarez M, Rodr\u00edguez Valencia LM, Seidman R, et al. Rheumatoid meningitis and infection in absence of rheumatoid arthritis history: review of 31 cases [J]. Clin Rheumatol. 2020;39(12):3833\u201345.","journal-title":"Clin Rheumatol"},{"key":"3751_CR25","doi-asserted-by":"publisher","first-page":"1065650","DOI":"10.3389\/fimmu.2023.1065650","volume":"14","author":"S Fan","year":"2023","unstructured":"Fan S, Zhao J, Hou B, et al. Rheumatoid meningitis: a rare neurological complication of rheumatoid arthritis [J]. Front Immunol. 2023;14:1065650.","journal-title":"Front Immunol"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03751-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-024-03751-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03751-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T08:12:10Z","timestamp":1721031130000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-024-03751-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3751"],"URL":"https:\/\/doi.org\/10.1186\/s12883-024-03751-8","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"3 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of Ningxia Medical University(NO: KYLL-2023-0363).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The consent was also obtained from the patient\u2019s relatives for publication of the cases, which is listed in the Related files for review.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"243"}}