Il-1antagonist Treatment in Recurrent Aseptic Meningitis Related to Familial Mediterranean Fever

Background Familial Mediterranean fever (FMF) is an autosomal recessive, auto-inflammatory disease, presenting with recurrent bouts of fever and polyserositis. FMF has been associated with central nervous system (CNS) manifestations such as Headache and Myalgia. The occurrence of other forms of nervous system involvement is rare, including seizures, sinus vein thrombosis, pseudotumor cerebri and more. There are only few case reports of aseptic meningitis due to FMF. Case presentation We present the case of a 14 year-old girl diagnosed with FMF, who experienced recurrent episodes of severe headache and aseptic meningitis while on maximal dose of colchicine therapy. She had a dramatic response to anakinra with symptoms resolving completely within a few days without recurrence. Subsequently, we identified seven cases in the literature describing recurrent aseptic meningitis in patients with underlying FMF; all showed response to colchicine treatment, without treatment failure. Conclusion Our case suggests a role for Interleukin 1 (IL-1) antagonists for cases of CNS involvement secondary to FMF in patients who fail to respond to colchicine, and might imply that anakinra could be effective in other auto-inflammatory diseases with CNS involvement.

A Case of Mollarets Meningitis In Apollo Hospitals Dhaka

Mollarets Meningitis is defined as a benign recurrent aseptic meningitis characterized by more than three episodes of fever, headache, meningeal irritation lasting typically 3-5 days. It has spontaneous recovery without any residual neurological deficit. Mollaret in 1944 described this extremely rare form of self-limiting aseptic recurrent benign meningitis. Here we present the report of a patient with Mollarets Meningitis with some atypical features. Early diagnosis may prevent prolonged hospital admissions, unnecessary investigations, and exposure to unnecessary medications, with their associated considerable costs.Pulse Vol.10 January-December 2017 p.42-46