Aseptic meningitis followed by mononeuritis multiplex in a patient with primary Sjögren’s syndrome

A 38-year-old woman was admitted to hospital because of fever and headache. Increased cerebrospinal cell count and protein without evidence of infection led to a diagnosis of aseptic meningitis. Although she improved with acyclovir and glyceol, she experienced left forearm pain and sensory disturban...

Full description

Bibliographic Details
Main Authors: Hideki Nakamura, Yutaka Tanikawa, Masahiro Nishihara, Masako Tsukamoto, Yosuke Nagasawa, Kumiko Akiya, Naotoshi Natori, Noboru Kitamura, Tadateru Takayama, Hideto Nakajima
Format: Article
Language:English
Published: SAGE Publishing 2023-08-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605231189121
Description
Summary:A 38-year-old woman was admitted to hospital because of fever and headache. Increased cerebrospinal cell count and protein without evidence of infection led to a diagnosis of aseptic meningitis. Although she improved with acyclovir and glyceol, she experienced left forearm pain and sensory disturbance with drop fingers. Poor derivation of compound muscle action potentials in the left radial nerve was observed, leading to a diagnosis of mononeuritis multiplex with sensorimotor neuropathy. Because the patient had primary Sjögren’s syndrome with anti-Ro/SS-A antibody and salivary gland hypofunction, treatment with methylprednisolone, intravenous immunoglobulin, and intravenous cyclophosphamide was followed by oral glucocorticoid therapy. After these intensive therapies, her drop fingers gradually improved, although sensory disturbance remained. In conclusion, we report a case of aseptic meningitis and subsequent mononeuritis multiplex that was successfully treated with intensive immunotherapy in a patient with primary Sjögren’s syndrome.
ISSN:1473-2300