Acute disseminated encephalomyelitis mimicking late CNS relapse of acute lymphoblastic leukaemia: case report

Kumar, Ram L.; Nijalingappa, S.; Grainger, John D.; Ismayl, Omar

doi:10.1186/1752-1947-1-4

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…The novel imaging technique 1 H-MRS is important in the diagnosis of CNS leukemia, and in differentiating it from other brain lesions in patients with leukemia. This is particularly vital when the characteristic imaging findings that usually appear on traditional images are absent (37)(38)(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have demonstrated that the misdiagnosis rate of CNS leukemia may be ≤75%, with misdiagnoses including intracranial hemorrhage, cerebral infarction, meningitis, infection, demyelinating multiple sclerosis, spinal cord compression syndrome and Guillain-Barre syndrome (38,39). It is possible to obtain pathological confirmation safely through stereotactic biopsy with minimal trauma (21,22).…”

Section: Discussionmentioning

confidence: 99%

“…Due to the diversity in pathological changes and imaging findings within CNS leukemia, it is challenging to identify the precise nature of CNS lesions in patients with leukemia, which is used to determine the type of treatment (38,39). Various studies have demonstrated that the misdiagnosis rate of CNS leukemia may be ≤75%, with misdiagnoses including intracranial hemorrhage, cerebral infarction, meningitis, infection, demyelinating multiple sclerosis, spinal cord compression syndrome and Guillain-Barre syndrome (38,39).…”

Section: Discussionmentioning

confidence: 99%

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Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

et al. 2017

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Abstract. The present study aimed to characterize the specific pathology and magnetic resonance imaging (MRI) findings observed in patients with leukemia with central nervous system (CNS) lesions, and to determine their value in the management of such patients. Lesions of the CNS were observed during and following treatment of leukemia. The data from stereotactic biopsy-proven pathology (12 patients) and MRI examinations (14 patients) were retrospectively evaluated. Proton-magnetic resonance-spectroscopy was performed in three patients. Factors that predisposed to lesions of the CNS were reviewed from the patient medical records. Among the 14 patients, eight had CNS leukemia, four had a CNS infection and two had a neurodegenerative disorder (one leukoencephalopathy and one glial cell hyperplasia). The clinical diagnosis based on clinical symptoms, signs and MRI features was not consistent with the pathological diagnosis in two patients. In one patient, the clinical diagnosis was a CNS infection; however, the patient's pathological diagnosis was CNS leukemia. In the other patient, the clinical diagnosis was CNS leukemia, but the pathological diagnosis was glial cell hyperplasia. CNS lesions in leukemia have a wide range of causes. Apart from the relapse of leukemia in the CNS, there are treatment-associated neurotoxicities and infections that are caused by immunocompromised states.As numerous leukemia-associated CNS lesions are treatable, early diagnosis is essential.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

et al. 2017

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“…Доминирование в нейровизуа лизационных данных, морфологической картине ГМ поражения миелина сближает их с группой де миелинизирующих заболеваний НС и паранеопла стическими синдромомами. В частности, острый рассеянный энцефаломиелит необходимо диффе ренцировать с острой демиелинизирующей энце фаломиелопатией после трансплантации костного мозга пациентам с острым лимфобластным лейко зом [10]. Наследуются лейкодистрофии по аутосом но рецессивному типу [2,8].…”

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Congenital and acquired mitochondrial disorders of the central nervous system

Никитина¹,

Правдина²

2014

Uč. zap. St.-Peterbg. gos. med. univ. im. Akad. I.P. Pavlova

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Clinical presentations of disorders of the nervous system manifest in young and middle-aged patients with congenital and acquired mitochondrial dysfunctions and cognitive disorders manifest in patients with mitochondrial diseases more often. Nowadays the effective methods of initial diagnosing of these conditions are neurological and neuropsychological examination of patients, using of biochemical markers of mitochondrial diseases: the indices of lactate, total homocysteine in plasma and liquor. Neuro-visual study (Magnetic resonance imaging of the brain, MR spectroscopy, tractography, diffusion-weighted magnetic resonance imaging of the brain, mitochondrial DNA typing) is actually used for the differential diagnosing of mitochondrial diseases with other disorders that are accompanied by demyelinating disorders.

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“…The association of hematological disease with ADEM is very rare. In total, six cases have been reported; three adults and three children . We describe here an adolescent who was diagnosed as ADEM after allogeneic BMT for a non‐malignant hematological disease.…”

mentioning

confidence: 99%

Acute disseminated encephalomyelitis after allogeneic bone marrow transplantation for pure red cell aplasia – A case report and review of the literature

Paisiou

Goussetis

Dimopoulou

et al. 2012

Pediatric Transplantation

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ADEM is a rare inflammatory demyelinating disease of the CNS, which usually presents after a viral infection or a vaccination. We report a 15-yr-old boy who was diagnosed with ADEM after an HLA-identical sibling allogeneic BMT for transfusion-dependent PRCA. His course was complicated with GVHD affecting the skin and lungs. Five months post-BMT, he developed neurological symptoms including sudden mental status alteration, dysarthria, facial nerve palsy, and acute paraplegia. The MRI revealed multifocal hyperintense lesions mainly in the subcortical white matter of the cerebrum, the brainstem, the basal ganglia, and the thalami. CSF examination was normal. There was no laboratory evidence of infection. The typical MRI findings and an acute monophasic clinical course were consistent with the diagnosis of ADEM. Clinical and radiological improvement was observed after treatment with high-dose steroids and IVIG. Complete neurologic recovery was achieved six months after the onset of symptoms. We present a rare case of ADEM post-BMT and review of the literature.

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Acute disseminated encephalomyelitis mimicking late CNS relapse of acute lymphoblastic leukaemia: case report

Abstract: Background: Acute encephalomyelopathy occurring after an allogeneic bone marrow transplant for leukaemia is a diagnostic emergency. The diagnosis can be challenging since there is a wide set of alternative diagnoses, including opportunistic infections and relapse of the leukaemia.

Cited by 9 publications

References 9 publications

Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

Congenital and acquired mitochondrial disorders of the central nervous system

Acute disseminated encephalomyelitis after allogeneic bone marrow transplantation for pure red cell aplasia – A case report and review of the literature

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