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Rheumatoid meningitis (RM) is a pachymeningitis rarely occurring in rheumatoid arthritis (RA). The pathophysiology of RM is not clear, though a diffuse vasculitis in the dura mater has been shown in some patients.1 Here we present a patient with RM who had a raised serum level of perinuclear antineutrophil cytoplasmic antibody (P-ANCA), which is known to be associated with vasculitic diseases.
A 72 year old woman was admitted to our hospital because of headache. Twenty two years before she had been diagnosed as having RA and treated with non-steroidal anti-inflammatory drugs, without complete remission. Seven months before admission, polyarthralgia deteriorated and a numbness of the hands and feet and a low grade fever occurred, and she lost 10 kg in 2 months. She was given prednisolone 15 mg/day …