CEREBRAL VASCULITIS COMPLICATING RHEUMATOID-ARTHRITIS

Central nervous system vasculitis is a rarely described complication o f rheumatoid arthritis. We report a case of cerebral vasculitis in a 5 5-year-old woman with a 7-year history of seropositive, nodular rheuma toid arthritis. Striking multifocal abnormalities of the white matter on magnetic resonance imaging led to a suspicion of vasculitis despite lack of clinical evidence of extracranial vasculitis and normal findi ngs on cerebrospinal fluid studies and cerebral angiography. After ins titution of treatment with glucocorticoids and azathioprine, she survi ved in stable condition for 14 months from the onset of symptoms. Post mortem examination of the brain revealed vasculitis and chronic ischem ic changes.