Primary cerebral immunoglobulin light chain amyloidoma in a patient with multiple sclerosis.
| Autor: | Traets MJM; Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, Netherlands M.J.M.Traets@umcutrecht.nl., Chuwonpad K; Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, Netherlands., Leguit RJ; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Frequin STFM; Department of Neurology, Sint Antonius Hospital, Nieuwegein, Netherlands., Minnema MC; Department of Hematology, University Medical Centre, Utrecht, Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2024 Jan 24; Vol. 17 (1). Date of Electronic Publication: 2024 Jan 24. |
| DOI: | 10.1136/bcr-2023-256537 |
| Abstrakt: | A man in his 60s, known with multiple sclerosis, presented with seizures and paresis of the left arm and leg. Brain imaging showed a white matter lesion, right parietal, which was progressive over the last 6 years and not typical for multiple sclerosis. Brain biopsy showed a B-cell infiltrate with IgA lambda monotypic plasma cell differentiation and amyloid deposits, typed as lambda immunoglobulin light chain (AL). Bone marrow biopsy and PET/CT ruled out a systemic lymphoma. Extended history taking, blood and urine testing (including cardiac biomarkers) identified no evidence of systemic amyloidosis-induced organ dysfunction.Primary cerebral AL amyloidoma is a very rare entity where optimal treatment is difficult to assess. The patient was treated with locally applied volumetric modulated arc radiotherapy, 24 Gy, divided in 12 fractions. Afterwards, the paresis of the left arm partially resolved, and the function of the left leg improved. Seizures did not occur anymore. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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