神経学的症候出現時に関節症状を認めない抗cyclic citrullinated peptides抗体陽性のリウマチ性髄膜炎の1例
症例は84歳女性．緩徐進行性の認知機能障害の経過中に失行が出現した．神経学的所見は認知機能障害，失行に加え左上下肢の筋力低下を認めた．頭部magnetic resonance imaging（MRI）で右側頭頭頂葉の髄膜のfluid attenuated inversion recovery（FLAIR），diffusion weighted Imaging（DWI）高信号を認め造影効果を有し，血液検査で抗cyclic citrullinated peptides（CCP）抗体が高値であった．脳生検ではくも膜下腔を中心とした炎症細胞浸潤を認めた．ステロイドで加療し臨床症候，検査所見ともに改善し...
Saved in:
| Published in | 臨床神経学 Vol. 56; no. 9; pp. 627 - 632 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本神経学会
2016
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0009-918X 1882-0654 |
| DOI | 10.5692/clinicalneurol.cn-000915 |
Cover
| Abstract | 症例は84歳女性．緩徐進行性の認知機能障害の経過中に失行が出現した．神経学的所見は認知機能障害，失行に加え左上下肢の筋力低下を認めた．頭部magnetic resonance imaging（MRI）で右側頭頭頂葉の髄膜のfluid attenuated inversion recovery（FLAIR），diffusion weighted Imaging（DWI）高信号を認め造影効果を有し，血液検査で抗cyclic citrullinated peptides（CCP）抗体が高値であった．脳生検ではくも膜下腔を中心とした炎症細胞浸潤を認めた．ステロイドで加療し臨床症候，検査所見ともに改善した．全経過を通じて関節症状は認めていない．本例は慢性髄膜炎の診断治療を考える上で貴重な症例である．発症時に関節症状のないリウマチ性髄膜炎の報告は稀で，本例では特に抗CCP抗体が高値であり，リウマチ性髄膜炎の発症機序を考える上でも稀有な症例である． |
|---|---|
| AbstractList | 症例は84歳女性．緩徐進行性の認知機能障害の経過中に失行が出現した．神経学的所見は認知機能障害，失行に加え左上下肢の筋力低下を認めた．頭部magnetic resonance imaging（MRI）で右側頭頭頂葉の髄膜のfluid attenuated inversion recovery（FLAIR），diffusion weighted Imaging（DWI）高信号を認め造影効果を有し，血液検査で抗cyclic citrullinated peptides（CCP）抗体が高値であった．脳生検ではくも膜下腔を中心とした炎症細胞浸潤を認めた．ステロイドで加療し臨床症候，検査所見ともに改善した．全経過を通じて関節症状は認めていない．本例は慢性髄膜炎の診断治療を考える上で貴重な症例である．発症時に関節症状のないリウマチ性髄膜炎の報告は稀で，本例では特に抗CCP抗体が高値であり，リウマチ性髄膜炎の発症機序を考える上でも稀有な症例である． |
| Author | 三島, 一彦 佐々木, 惇 棚橋, 紀夫 安部, 鉄也 内野, 晃 髙尾, 昌樹 |
| Author_xml | – sequence: 1 fullname: 佐々木, 惇 organization: 埼玉医科大学病院病理診断部 – sequence: 1 fullname: 棚橋, 紀夫 organization: 埼玉医科大学国際医療センター脳卒中内科 – sequence: 1 fullname: 三島, 一彦 organization: 埼玉医科大学国際医療センター脳脊髄腫瘍科 – sequence: 1 fullname: 内野, 晃 organization: 埼玉医科大学国際医療センター画像診断科 – sequence: 1 fullname: 安部, 鉄也 organization: 埼玉医科大学国際医療センター脳卒中内科 – sequence: 1 fullname: 髙尾, 昌樹 organization: 埼玉医科大学国際医療センター脳卒中内科 |
| BookMark | eNpVkM9KAlEUxi9hkJnv4AuM3Tszd5xZhvQPpDYF7Ybr9U6NTKPMjAt3zigJ9g8KEiNcBBko1aoWgb7MVUffohGDaHMO5_cdDt_51kHMLtkMgBSCaaxo4ia1TNukxLJZxSlZaWoLEEIN4RUQR6oqClDBcgzEF1DQkHqyBpKua-YXM9ZUJMdBM3zphp9Xk7de-NgI281JrTNpfoe3o2kn4P5g_vAcftQiHra-eHA361_zwOd-n_uNaatNq5EBmqKm51SsyArxWCFVZmXPLDA30sfD-3lnOK29cv-d1_s86PF6l9f9iMwHjdnFUxjcRBIajy43wKpBLJclf3sCHO9sH2X3hNzh7n52KycURUWEgswMCUOcp5IqQYwpFRXIDKjliUFRRqSyQqEIIUIM5qMXM4aMoapQghWDIIZUKQEOlneLrkdOmV52zHPiVHXieCa1mP4_UR0rurYo1NaXyf4tnhFHLxLpByqrn38 |
| ContentType | Journal Article |
| Copyright | 2016 日本神経学会 |
| Copyright_xml | – notice: 2016 日本神経学会 |
| DOI | 10.5692/clinicalneurol.cn-000915 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1882-0654 |
| EndPage | 632 |
| ExternalDocumentID | article_clinicalneurol_56_9_56_cn_000915_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS JSF OK1 P2P RJT |
| ID | FETCH-LOGICAL-j2620-4ef3505bc383055cc260ef09bafc172c46c020011e0b9597f45086ca56fa1e183 |
| ISSN | 0009-918X |
| IngestDate | Wed Sep 03 06:23:56 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 9 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2620-4ef3505bc383055cc260ef09bafc172c46c020011e0b9597f45086ca56fa1e183 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/clinicalneurol/56/9/56_cn-000915/_article/-char/ja |
| PageCount | 6 |
| ParticipantIDs | jstage_primary_article_clinicalneurol_56_9_56_cn_000915_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 20160000 |
| PublicationDateYYYYMMDD | 2016-01-01 |
| PublicationDate_xml | – year: 2016 text: 20160000 |
| PublicationDecade | 2010 |
| PublicationTitle | 臨床神経学 |
| PublicationTitleAlternate | 臨床神経学 |
| PublicationYear | 2016 |
| Publisher | 日本神経学会 |
| Publisher_xml | – name: 日本神経学会 |
| References | 5) Starosta MA, Brandwein SR. Clinical manifestations and treatment of rheumatoid pachymeningitis. Neurology 2007;68:1079-1080. 14) Reiber H, Peter JB. Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs. J Neurol Sci 2001;184:101-122. 15) Ramos M, Mandybur TI. Cerebral vasculitis in rheumatoid arthritis. Arch Neurol 1975;32:271-275. 9) Muramatsu K, Tanaka H, Taguchi T. Peripheral neuropathies of forearm and hand in rheumatoid arthritis: diagnosis and options for treatment. Rheumatol Int 2008;28:951-957. 6) Kim HY, Park JH, Oh HE, et al. A case of rheumatoid meningitis: pathologic and magnetic resonance imaging findings. Neurol Sci 2011;32:1191-1194. 2) Maher JA. Dural nodules in rheumatoid arthritis; report of a case. AMA Arch Pathol 1954;58:354-359. 8) Magaki S, Chang E, Hammond RR, et al. Two cases of rheumatoid meningitis. Neuropathology 2015;8:10. 12) Koide R, Isoo A, Ishii K, et al. Rheumatoid leptomeningitis: rare complication of rheumatoid arthritis. Clin Rheumatol 2009;28:1117-1119. 4) Agildere AM, Tutar NU, Yücel E, et al. Pachymeningitis and optic neuritis in rheumatoid arthritis: MRI findings. Br J Radiol 1999;72:404-407. 13) Krysl D, Zamecnik J, Senolt L, et al. Chronic repetitive nonprogressive epilepsia partialis continua due to rheumatoid meningitis. Seizure 2013;22:80-82. 1) Ellman P, Cudkowicz L, Elwood JS. Widespread serous membrane involvement by rheumatoid nodules. J Clin Pathol 1954;7:239-244. 3) Markenson JA, McDougal JS, Tsairis P, et al. Rheumatoid meningitis: a localized immune process. Ann Intern Med 1979;90:786-789. 16) Ishigami A, Ohsawa T, Hiratsuka M, et al. Abnormal accumulation of citrullinated proteins catalyzed by peptidylarginine deiminase in hippocampal extracts from patients with Alzheimer’s disease. J Neurosci Res 2005;80:120-128. 7) Jones SE, Belsley NA, McLoud TC, et al. Rheumatoid meningitis: radiologic and pathologic correlation. Am J Roentgenol 2006;186:1181-1183. 10) Kato T, Hoshi K, Sekijima Y, et al. Rheumatoid meningitis: an autopsy report and review of the literature. Clin Rheumatol 2003;22:475-480. 17) Suzuki A, Yamada R, Chang X, et al. Functional haplotypes of PADI4, encoding citrullinating enzyme peptidylarginine deminase 4, are associated with rheumatoid arthritis. Nat Genet 2003;34:395-402. 11) Schmid L, Müller M, Treumann T, et al. Induction of complete and sustained remission of rheumatoid pachymeningitis by rituximab. Arthritis Rheum 2009;60:1632-1634. 18) Klareskog L, Ronnelid J, Lunberg K, et al. Immunity to citrullinated proteins in rheumatoid arthritis. Annu Rev Immunol 2008;26:651-675. |
| References_xml | – reference: 10) Kato T, Hoshi K, Sekijima Y, et al. Rheumatoid meningitis: an autopsy report and review of the literature. Clin Rheumatol 2003;22:475-480. – reference: 3) Markenson JA, McDougal JS, Tsairis P, et al. Rheumatoid meningitis: a localized immune process. Ann Intern Med 1979;90:786-789. – reference: 8) Magaki S, Chang E, Hammond RR, et al. Two cases of rheumatoid meningitis. Neuropathology 2015;8:10. – reference: 13) Krysl D, Zamecnik J, Senolt L, et al. Chronic repetitive nonprogressive epilepsia partialis continua due to rheumatoid meningitis. Seizure 2013;22:80-82. – reference: 15) Ramos M, Mandybur TI. Cerebral vasculitis in rheumatoid arthritis. Arch Neurol 1975;32:271-275. – reference: 2) Maher JA. Dural nodules in rheumatoid arthritis; report of a case. AMA Arch Pathol 1954;58:354-359. – reference: 14) Reiber H, Peter JB. Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs. J Neurol Sci 2001;184:101-122. – reference: 4) Agildere AM, Tutar NU, Yücel E, et al. Pachymeningitis and optic neuritis in rheumatoid arthritis: MRI findings. Br J Radiol 1999;72:404-407. – reference: 18) Klareskog L, Ronnelid J, Lunberg K, et al. Immunity to citrullinated proteins in rheumatoid arthritis. Annu Rev Immunol 2008;26:651-675. – reference: 17) Suzuki A, Yamada R, Chang X, et al. Functional haplotypes of PADI4, encoding citrullinating enzyme peptidylarginine deminase 4, are associated with rheumatoid arthritis. Nat Genet 2003;34:395-402. – reference: 9) Muramatsu K, Tanaka H, Taguchi T. Peripheral neuropathies of forearm and hand in rheumatoid arthritis: diagnosis and options for treatment. Rheumatol Int 2008;28:951-957. – reference: 6) Kim HY, Park JH, Oh HE, et al. A case of rheumatoid meningitis: pathologic and magnetic resonance imaging findings. Neurol Sci 2011;32:1191-1194. – reference: 11) Schmid L, Müller M, Treumann T, et al. Induction of complete and sustained remission of rheumatoid pachymeningitis by rituximab. Arthritis Rheum 2009;60:1632-1634. – reference: 1) Ellman P, Cudkowicz L, Elwood JS. Widespread serous membrane involvement by rheumatoid nodules. J Clin Pathol 1954;7:239-244. – reference: 5) Starosta MA, Brandwein SR. Clinical manifestations and treatment of rheumatoid pachymeningitis. Neurology 2007;68:1079-1080. – reference: 12) Koide R, Isoo A, Ishii K, et al. Rheumatoid leptomeningitis: rare complication of rheumatoid arthritis. Clin Rheumatol 2009;28:1117-1119. – reference: 7) Jones SE, Belsley NA, McLoud TC, et al. Rheumatoid meningitis: radiologic and pathologic correlation. Am J Roentgenol 2006;186:1181-1183. – reference: 16) Ishigami A, Ohsawa T, Hiratsuka M, et al. Abnormal accumulation of citrullinated proteins catalyzed by peptidylarginine deiminase in hippocampal extracts from patients with Alzheimer’s disease. J Neurosci Res 2005;80:120-128. |
| SSID | ssib000959814 ssib058494234 ssib002821941 ssib000940416 ssib002484599 ssib005879791 ssj0060813 |
| Score | 2.090655 |
| Snippet | 症例は84歳女性．緩徐進行性の認知機能障害の経過中に失行が出現した．神経学的所見は認知機能障害，失行に加え左上下肢の筋力低下を認めた．頭部magnetic resonance... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 627 |
| SubjectTerms | リウマチ性髄膜炎 抗CCP抗体 関節リウマチ |
| Title | 神経学的症候出現時に関節症状を認めない抗cyclic citrullinated peptides抗体陽性のリウマチ性髄膜炎の1例 |
| URI | https://www.jstage.jst.go.jp/article/clinicalneurol/56/9/56_cn-000915/_article/-char/ja |
| Volume | 56 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 臨床神経学, 2016, Vol.56(9), pp.627-632 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1882-0654 dateEnd: 99991231 omitProxy: true ssIdentifier: ssib000959814 issn: 0009-918X databaseCode: KQ8 dateStart: 20080101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrR1Na9RANJQK4kX8xG_24By3ZpPMZOZmsk0tQgWhhd5CMrtBFlmL9KKn7rZYqF-gYKlID4IVWtSTHoT2z6Rt2n_hezPJNilatHgJw8ybN-9jJvPeZN6LYdyU1JKcSbfOhAQHxeJJnbNEwMswjuPE5SJShzkT99j4lHN3mk4PDd8uR5fMxiPy6W_jSo6jVagDvWKU7D9odoAUKqAM-oUnaBief6VjErjEo0QEWPAp4U0SUOKNEo9hjfAId1TBJeDzQxNeaxCqAPAeNvEx4kN3hvXcIoENpiXxfBIIIhjxLDXEGHY8wANPj_hMAVtEAAwnHow1mtcAhhyPlxeQDIa9hCufSMyrLTHaA_OBR2jyzuDdmha8sQooEjjEHyXCVoQILGOTSTy3wB2ogl0MYimmVY0ompCQQS-BbCEhnHBgt6n4AGKDAcKGGjUg3C-b7KoDCIGj3EBo3DtC7MX8Leg3FXKTcKpk3EQ0MKkVWdDgHsCDsG3UGBZAFb4GA_yOEj7gd4CBCn6gSynTt1EbCl7XKni_Sg9FrpEMgdzwoCAD9W6Xz350UKpap6pd8ZoT3zxyxsHgTWChshEK2OfUX53BDNB7HzpbGGtc3hx11vf8JSBKOx3TKR1yo4npQ-rD-zFlAvP7FkG-KkXrwxHZxVwGQofxHsp2nq-lsNolpCwU-JDdUHcNB4APosdhBzykExaeyOG1jPslB0M4ZuW7uqCCl-4NWA53qKgcQDTKkd2Uu8I9yCYF1roA_8MpbD0GBvXgX40oTn1XENm-9SemwdTtgONXXBpVduzkGeN07oDWPM3YWWOoE50zTk7kV2zOG4vZp9Xs-4udL2vZ-4VseXFnbmVn8Wf2emt3pZ_2Nvbffcy-zUF9tvQj7b_ZW3-Z9ntpbz3tLewuLevFXass7lqxuKF9e_Pt_srm7tzntPc1nV9P-2vp_Go634Oa_Y2FvWcfsv4raGpsbz2_YEyNBZPN8Xr-t5Z6B39qUXfaiQ3uVCxtjlkEpbSY2U5MEUeJBC9JOkyaeIGz0TZj0IKbOOAbMhlRlkSNNlgWF43h7qNu-5JRa4NPEZmNlt2iiWMKM-bgVMRxS3LUV9K6bNzRIgxndEqe8LjT5sp_w3TVOIUrVJ_OXjOGQc7t6-CvzMY31JT8BbK1Gdk |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E7%A5%9E%E7%B5%8C%E5%AD%A6%E7%9A%84%E7%97%87%E5%80%99%E5%87%BA%E7%8F%BE%E6%99%82%E3%81%AB%E9%96%A2%E7%AF%80%E7%97%87%E7%8A%B6%E3%82%92%E8%AA%8D%E3%82%81%E3%81%AA%E3%81%84%E6%8A%97cyclic+citrullinated+peptides%E6%8A%97%E4%BD%93%E9%99%BD%E6%80%A7%E3%81%AE%E3%83%AA%E3%82%A6%E3%83%9E%E3%83%81%E6%80%A7%E9%AB%84%E8%86%9C%E7%82%8E%E3%81%AE1%E4%BE%8B&rft.jtitle=%E8%87%A8%E5%BA%8A%E7%A5%9E%E7%B5%8C%E5%AD%A6&rft.au=%E4%BD%90%E3%80%85%E6%9C%A8%2C+%E6%83%87&rft.au=%E6%A3%9A%E6%A9%8B%2C+%E7%B4%80%E5%A4%AB&rft.au=%E4%B8%89%E5%B3%B6%2C+%E4%B8%80%E5%BD%A6&rft.au=%E5%86%85%E9%87%8E%2C+%E6%99%83&rft.date=2016&rft.pub=%E6%97%A5%E6%9C%AC%E7%A5%9E%E7%B5%8C%E5%AD%A6%E4%BC%9A&rft.issn=0009-918X&rft.eissn=1882-0654&rft.volume=56&rft.issue=9&rft.spage=627&rft.epage=632&rft_id=info:doi/10.5692%2Fclinicalneurol.cn-000915&rft.externalDocID=article_clinicalneurol_56_9_56_cn_000915_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0009-918X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0009-918X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0009-918X&client=summon |