Abstract
BackgroundImmunoglobulin associated meningitis is a rare disease that mimics infectious meningitis. This is, to our knowledge, the first case of Immunoglobulin-associated meningitis described in a patient with Systemic Lupus Erythematosus and hypogammaglobulinemia secondary to Rituximab.Case presentationA 46-year-old female with a past medical history of Systemic Lupus Erythematosus, presented with meningismus 36 h after first infusion of intravenous immunoglobulin. The cerebrospinal fluid analysis showed neutrophilic pleocytosis and hyperproteinorrachia. All microbiological tests were negative. The patient recovered remarkably fast without sequela after just five days of antibiotic therapy.ConclusionSystemic Lupus Erythematosus is a well-documented risk factor for aseptic meningitis associated with other drugs. Possibly, it is also a risk factor for Immunoglobulin associated meningitis. This diagnosis, although rare, should be considered in patients receiving Immunoglobulin since it is a self-limited condition and treatment is supportive.
Highlights
Immunoglobulin associated meningitis is a rare disease that mimics infectious meningitis
Systemic Lupus Erythematosus is a well-documented risk factor for aseptic meningitis associated with other drugs
The medicines most commonly associated with aseptic meningitis are non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, intravenous immunoglobulin (IVIG) and OKT3 antibodies [3]
Summary
Systemic Lupus Erythematosus is a well-documented risk factor for aseptic meningitis associated with other drugs. It is a risk factor for Immunoglobulin associated meningitis. This diagnosis, rare, should be considered in patients receiving Immunoglobulin since it is a self-limited condition and treatment is supportive
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