Pentoxifylline-induced aseptic meningitis in a patient with mixed connective tissue disease.

Abstract

Drug-induced aseptic meningitis (DIAM) mainly occurs with nonsteroidal anti-inflammatory drugs (NSAID), antibiotics, IV immunoglobulins, anti-CD3 monoclonal antibodies, intrathecal agents, and vaccines.1,2⇓ Systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) are the most frequent underlying conditions associated with DIAM, especially when caused by NSAIDs.1,2⇓ We report a case of pentoxifylline-induced aseptic meningitis in a patient with MCTD. A 37-year-old Lebanese woman had a 16-year history of MCTD with Raynaud’s phenomenon, distal inflammatory arthralgias, neutropenia, lymphopenia, positive erythrocyte Coombs’ test, high speckled antinuclear antibodies, anti-SSA, high anti-RNP, and no anti–double-stranded DNA (dsDNA) antibodies. She was prescribed hydroxychloroquine. At the age of 34, chilblain lupus affected fingers, and anti-dsDNA antibodies were detected. Thalidomide was given with the hydroxychloroquine but rapidly stopped due to the occurrence of high fever, chills, arthralgias, and rash. She completely recovered after thalidomide discontinuation. One year later, because of Raynaud’s phenomenon, pentoxifylline was started …