Central and peripheral nervous system immune-mediated demyelinating disease after allogeneic hematopoietic stem cell transplantation

Journal of Neuroimmunology
M I Stefanou, F Bischof

Abstract

We aimed to evaluate clinical and diagnostic features of central and peripheral immune-mediated demyelinating disease (CPID) in allogeneic hematopoietic stem cell transplantation (aHSCT) recipients. CPID refers to the late-onset, immune-mediated neurological complications following aHSCT, when other frequent differential diagnoses have been ruled out, and when symptoms and signs of systemic GvHD manifestations are absent. Case records at the University of Tuebingen, between 2001 and 2015, were screened to identify patients with CPID after aHSCT. Seven patients who developed CPID after aHSCT were identified. The average time interval from aHSCT until onset of CPID was 2.6 (±2.8) years (mean±SD). The most prevalent manifestations of CPID were optic neuritis and/or myelitis and polyneuropathy. Cerebrospinal fluid analyses involved elevated protein concentration and lymphocytic pleocytosis, while oligoclonal bands in CSF, but not in serum, were detected in 28% of cases. Aquaporin-4-antibodies were consistently absent. MRI studies showed features suggestive of demyelination processes, with cerebral and/or spinal cord white-matter involvement, and features compatible with cerebral vasculitis. Corticosteroids, Immunoglobulins, Cycloph...Continue Reading

Citations

Sep 29, 2019·Annals of Clinical and Translational Neurology·Maria GavriilakiVasilis Kimiskidis
Aug 1, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Yunxia ZhaoWei Dong
Oct 5, 2021·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Jan LestakMartin Fus

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