Korean J Med.  2000 Oct;59(4):433-437.

A case of cerebral demyelinating disease after allogeneic bone marrow transplantation

• Lee JM
• Lee HG
• Hong JR
• Jung SI
• Suh YL
• Na DG

Abstract

We report a case of cerebral demyelinating disease developed in a 24-year-old male who underwent allogeneic bone marrow transplantation (BMT) from a HLA-matched unrelated donor for the treatment of acute myelogenous leukemia in the first complete remission. At the sixteenth month after BMT, he revealed rapidly progressive neurological signs as motor weakness of left leg, urinary incontinence, and dysarthria. There was no evidence of chronic graft-versus-host disease or any infection. Cyclosporin was tapered off two months before the event. Magnetic resonance imaging (MRI) demonstrated widespread changes in white matter with peripheral rim enhancement in contrast media. Stereotactic brain biopsy from the lesions disclosed demyelination associated with active phagocytosis of myelin. He was treated with dexamethasone 4mg IV every 12 hours for 20 days, which resulted in the complete recovery of neurological defects and the slightly decreased extent of brain lesions on MRI. With oral prednisolone 50mg daily, which were tapered over the next 3 months, the follow-up MRI in a month interval demonstrated markedly decreased size and number of the previous lesions. He has been doing well without any neurological sequelae for the last twelve months since the last MRI.

Keyword

Bone marrow transplantation; Leukemia; Myelocytic; Acute; Demyelinating Diseases; Steroids

MeSH Terms

Biopsy
Bone Marrow Transplantation*
Bone Marrow*
Brain
Contrast Media
Cyclosporine
Demyelinating Diseases*
Dexamethasone
Dysarthria
Follow-Up Studies
Graft vs Host Disease
Humans
Leg
Leukemia
Leukemia, Myeloid, Acute
Magnetic Resonance Imaging
Male
Myelin Sheath
Phagocytosis
Prednisolone
Steroids
Unrelated Donors
Urinary Incontinence
Young Adult
Contrast Media
Cyclosporine
Dexamethasone
Prednisolone
Steroids