Recurrent Aseptic Meningitis in an Elderly Man

NONINFECTIOUS meningeal involvement in systemic lupus erythematosus (SLE) occurs in approximately 8% of cases and is almost always associated with diffuse neurological deficits. The only well-documented case of aseptic meningitis without other neurologic or psychiatric symptoms was that of a patient with known SLE in whom the VDRL test, fluorescent treponemal antibody absorption test, antinuclear antibody test, and lupus erythematosus preparation were positive.1Aseptic meningitis as a prodromal manifestation of SLE in a seronegative patient has not been described, to our knowledge. We report such a case. Report of a Case A 61-year-old man was admitted to David Grant USAF Medical Center in July 1974 with a two-month history of headaches, generalized myalgia, fever, nausea, anorexia, and a weight loss of 6.8 kg (15 lb). Physical examination results were entirely within normal limits. Laboratory tests showed a hematocrit reading of 35.8%, white blood cell (WBC) counts of 3,200 and