BMJ Case Reports 2016; doi:10.1136/bcr-2016-217418

Adhesive arachnoiditis in mixed connective tissue disease: a rare neurological manifestation

Open Access
  1. Alexander Fraser1,2
  1. 1Rheumatology Department, University Hospital Limerick, Limerick, Ireland
  2. 2Graduate entry medical school, University of Limerick, Limerick, Ireland
  1. Correspondence to Dr Maria Usman Khan, drmariakhalid{at}
  • Accepted 9 November 2016
  • Published 16 December 2016


The overall incidence of neurological manifestations is relatively low among patients with mixed connective tissue disease (MCTD). We recently encountered a case of autoimmune adhesive arachnoiditis in a young woman with 7 years history of MCTD who presented with severe back pain and myeloradiculopathic symptoms of lower limbs. To the best of our knowledge, adhesive arachnoiditis in an MCTD patient has never been previously reported. We report here this rare case, with the clinical picture and supportive ancillary data, including serology, cerebral spinal fluid analysis, electrophysiological evaluation and spinal neuroimaging, that is, MRI and CT (CT scan) of thoracic and lumbar spine. Her neurological deficit improved after augmenting her immunosuppressant therapy. Our case suggests that adhesive arachnoiditis can contribute to significant neurological deficits in MCTD and therefore requires ongoing surveillance.


  • Contributors MUK was the chief author of the article and undertook most of the literature review. AF was the primary treating physician of the patient and was actively involved in subsequent revision of the article. JAJD consulted on the management of the patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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