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

• Published in: Modern rheumatology 2008-04, Vol.18 (2), p.184-188
• Main Authors: Fujita, Yoshimasa, Fujii, Takao, Nakashima, Ran, Tanaka, Masao, Mimori, Tsuneyo
• Format: Article
• Language: English
• Subjects: Adult; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Autoantibodies - immunology; Body fluids; Case Report; Cells, Cultured; Cytokines; Cytokines - cerebrospinal fluid; Female; Humans; Inflammatory diseases; Interferon-gamma - cerebrospinal fluid; Interleukin-4 - cerebrospinal fluid; Interleukin-6 - cerebrospinal fluid; Leukocytes, Mononuclear - drug effects; Leukocytes, Mononuclear - immunology; Lymphocyte Activation - drug effects; Medicine; Medicine & Public Health; Meningitis; 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; Orthopedics; Prednisolone - therapeutic use; Rheumatology; Ribonucleoprotein, U1 Small Nuclear - immunology; Treatment Outcome
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1007/s10165-008-0022-7

In this paper, we report two patients with mixed connective tissue disease (MCTD) who developed aseptic meningitis. In both cases, the concentrations of IFN-γ 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-γ 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-γ 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.