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Rheumatoid arthritis complicated by pachy‐ and leptomeningeal rheumatoid nodule‐tike granulomas and systemic vasculitis
Author(s) -
Kamio Naohiko,
Kuramochi Shlgeru,
Wang RuoJiao,
Hirose Shigemichi,
Hosoda Yasuhiro
Publication year - 1996
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1996.tb03649.x
Subject(s) - rheumatoid nodule , medicine , rheumatoid arthritis , fibrinoid necrosis , pathology , vasculitis , necrotizing vasculitis , granuloma , nodule (geology) , immunology , disease , paleontology , biology
Rheumatoid nodule is a frequent and characteristic extra‐articular manifestation of rheumatoid arthritis (RA). Its involvement of central nervous system is a rare occurrence with only a few reported cases. A 78‐year‐old man with severe arthritis showing the formation of rheumatoid nodule‐like granulomas in the dura and subarachnoid space along with the spleen is presented. The characteristic morphological finding of the granulomas was the presence of neutrophlls and the absence of definite fibrinoid necrosis, which differed from the typical features of rheumatoid nodules previously described. The diagnosis should be based on the exclusion of diseases that may cause similar granulomatous reactions including infectious diseases. Additionally, there was systemic necrotizing vasculitis in the dura and multiple cerebral Infarcts, although the association between vasculitis and cerebral infarcts was not clear.