Medicina (Buenos Aires)
versión On-line ISSN 1669-9106
VAZQUEZ, Fernando J.; BEGUELIN, Yuqueri; SCHUTZ, Natalia y MAYORGA, Luis M.. Colagenopathy and recurrent aseptic meningitis in an 88 year old patient. Medicina (B. Aires) [online]. 2004, vol.64, n.1, pp. 54-56. ISSN 1669-9106.
Recurrent aseptic meningitis (RAM) infrequent in elderly patients and generally secondary to drugs. Its association with rheumatologic diseases is also seldom reported in the elderly. Sjögren Syndrome (SS) sometimes affects the central nevous system, but the association between recurrent meningitis and SS is rare, specially in this age-group. We present an 88 year-old autovalid patient, with a history of xerostomia, xerophthalmia, Raynaud, dysphagia, and recurrent parotid enlargement. In 2001 she developed a lymphocytic meningitis with a complete remission. A year later, she developed again an aseptic lymphocytic meningitis. We ruled out infeccious causes. We found a FAN titer 1/160 with a nucleolar-mottled pattern, positive anti Ro and anti RNP antibodies and a positive lupus anticoagulant. We confirmed the ocular dryness and the lip biopsy was compatible with the diagnosis of SS. She had a good outcome with a complete remission without treatment in 10 days. We believe that this is a case of mixed connective tissue disease (MCTD) with predominant symptoms of SS, that developed a recurrent meningitis in its pure form. MCTD and SS should be considered in the differential diagnoses of RAM, also in the elderly.
Palabras clave : Sjögrens Syndrome; recurrent meningitis; aseptic meningitis; elderly.