Aseptic meningitis in mixed connective tissue disease: cytokine and anti-U1RNP antibodies in cerebrospinal fluids from two different cases

Mod Rheumatol. 2008;18(2):184-8. doi: 10.1007/s10165-008-0022-7. Epub 2008 Feb 19.

Abstract

In this paper, we report two patients with mixed connective tissue disease (MCTD) who developed aseptic meningitis. In both cases, the concentrations of IFN-gamma and IL-6 in cerebrospinal fluid (CSF) were increased. In the first case, with non-steroidal anti-inflammatory drugs (NSAIDs)-induced meningitis, where anti-U1RNP antibodies (Abs) were not detected in CSF, NSAIDs induced both IFN-gamma and IL-6 secretion from peripheral blood mononuclear cells in vitro. In the second case, with disease-associated meningitis, anti-U1RNP Abs were detected also in CSF. Of note, anti-U1RNP Abs appeared to be more concentrated in CSF than in serum and CSF-anti-U1RNP Ab titer was correlated with disease activity. We suggest that IFN-gamma and IL-6 may be involved in both disease-associated and drug-induced aseptic meningitis, whereas CSF-anti-U1RNP Abs is detected only in a patient with MCTD-associated aseptic meningitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Autoantibodies / immunology*
  • Cells, Cultured
  • Cytokines / cerebrospinal fluid*
  • Female
  • Humans
  • Interferon-gamma / cerebrospinal fluid
  • Interleukin-4 / cerebrospinal fluid
  • Interleukin-6 / cerebrospinal fluid
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / immunology
  • Lymphocyte Activation / drug effects
  • Meningitis, Aseptic / cerebrospinal fluid
  • Meningitis, Aseptic / diagnosis
  • Meningitis, Aseptic / immunology*
  • Mixed Connective Tissue Disease / cerebrospinal fluid
  • Mixed Connective Tissue Disease / diagnosis
  • Mixed Connective Tissue Disease / immunology*
  • Prednisolone / therapeutic use
  • Ribonucleoprotein, U1 Small Nuclear / immunology*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Autoantibodies
  • Cytokines
  • Interleukin-6
  • Ribonucleoprotein, U1 Small Nuclear
  • Interleukin-4
  • Interferon-gamma
  • Prednisolone