Cognitive decline with chronic meningitis secondary to a COX-2 inhibitor.

Abstract:

:Non-steroidal anti-inflammatory drugs are currently being investigated as agents to reduce the incidence and progression of Alzheimer's disease. Paradoxically they have also been reported to induce deleterious effects on the central nervous system, including aseptic meningitis and cognitive decline in the elderly. We report a case of a 72-year-old woman who presented with a 6-week history of profound confusion whilst being treated with rofecoxib, a COX-2 inhibitor. Lumbar puncture demonstrated a lymphocytic pleocytosis with increased protein and normal glucose. Complete clinical remission occurred 5 days after the rofecoxib was ceased with no other cause found despite extensive investigation. This case illustrates that non-steroidal anti-inflammatory drugs, including the new COX-2 inhibitors, can produce chronic lymphocytic meningitis, which may manifest as cognitive decline. This mechanism may account for other case reports and epidemiological evidence of the association between non-steroidal anti-inflammatory drugs and confusion.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Ashton D,Kim P,Griffiths N,Beran R

doi

10.1093/ageing/afh112

subject

Has Abstract

pub_date

2004-07-01 00:00:00

pages

408-9

issue

4

eissn

0002-0729

issn

1468-2834

pii

afh112

journal_volume

33

pub_type

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