PMID- 32973648
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 11
DP  - 2020
TI  - Case Report: A Case of Severe Clinical Deterioration in a Patient With Multiple 
      Sclerosis.
PG  - 782
LID - 10.3389/fneur.2020.00782 [doi]
LID - 782
AB  - Tumefactive multiple sclerosis (MS) is a rare variant of MS that may lead to a 
      rapidly progressive clinical deterioration requiring a multidisciplinary 
      diagnostic workup. Our report describes the diagnostic and therapeutic approach 
      of a rare and extremely severe course of MS. A 51-year-old man with an 8-year 
      history of relapsing-remitting MS (RRMS) was admitted with a subacute progressive 
      left lower limb weakness and deterioration of walking ability. After extensive 
      investigations including repeated MRI, microbiological, serological, 
      cerebrospinal fluid (CSF) studies, and finally brain biopsy, the diagnosis of a 
      tumefactive MS lesion was confirmed. Despite repeated intravenous (IV) steroids 
      as well as plasma exchanges and IV foscarnet and ganciclovir owing to low copy 
      numbers of human herpesvirus 6 (HHV-6) DNA in polymerase chain reaction (PCR) 
      analysis, the patient did not recover. The clinical presentation of tumefactive 
      MS is rare and variable. Brain biopsy for histopathological workup should be 
      considered in immunocompromised patients with rapidly progressive clinical 
      deterioration with brain lesions of uncertain cause.
CI  - Copyright (c) 2020 Breitkopf, Aytulun, Forster, Kraus, Turowski, Huppert, Goebels, 
      Hefter, Aktas, Metz, Bruck, Reifenberger, Hartung and Albrecht.
FAU - Breitkopf, Katharina
AU  - Breitkopf K
AD  - German Center for Vertigo and Balance Disorders, Ludwig Maximilian University of 
      Munich, Munich, Germany.
AD  - Department of Neurology, Ludwig Maximilian University of Munich, Munich, Germany.
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Aytulun, Aykut
AU  - Aytulun A
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Forster, Moritz
AU  - Forster M
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Kraus, Bastian
AU  - Kraus B
AD  - Department of Neuroradiology, Medical Faculty, Heinrich Heine University 
      Dusseldorf, Dusseldorf, Germany.
FAU - Turowski, Bernd
AU  - Turowski B
AD  - Department of Neuroradiology, Medical Faculty, Heinrich Heine University 
      Dusseldorf, Dusseldorf, Germany.
FAU - Huppert, Doreen
AU  - Huppert D
AD  - German Center for Vertigo and Balance Disorders, Ludwig Maximilian University of 
      Munich, Munich, Germany.
FAU - Goebels, Norbert
AU  - Goebels N
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Hefter, Harald
AU  - Hefter H
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Aktas, Orhan
AU  - Aktas O
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Metz, Imke
AU  - Metz I
AD  - Institute of Neuropathology, University Medical Center Gottingen, Gottingen, 
      Germany.
FAU - Bruck, Wolfgang
AU  - Bruck W
AD  - Institute of Neuropathology, University Medical Center Gottingen, Gottingen, 
      Germany.
FAU - Reifenberger, Guido
AU  - Reifenberger G
AD  - Institute of Neuropathology, Medical Faculty, Heinrich Heine University 
      Dusseldorf, Dusseldorf, Germany.
FAU - Hartung, Hans-Peter
AU  - Hartung HP
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Albrecht, Philipp
AU  - Albrecht P
AD  - Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, 
      Dusseldorf, Germany.
LA  - eng
PT  - Journal Article
DEP - 20200818
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7461937
OTO - NOTNLM
OT  - demyelinating disease
OT  - immunocompromised multiple sclerosis patient
OT  - multiple sclerosis
OT  - multiple sclerosis rebound
OT  - progressive brain lesions
OT  - tumefactive multiple sclerosis
EDAT- 2020/09/26 06:00
MHDA- 2020/09/26 06:01
PMCR- 2020/08/18
CRDT- 2020/09/25 06:01
PHST- 2020/05/17 00:00 [received]
PHST- 2020/06/25 00:00 [accepted]
PHST- 2020/09/25 06:01 [entrez]
PHST- 2020/09/26 06:00 [pubmed]
PHST- 2020/09/26 06:01 [medline]
PHST- 2020/08/18 00:00 [pmc-release]
AID - 10.3389/fneur.2020.00782 [doi]
PST - epublish
SO  - Front Neurol. 2020 Aug 18;11:782. doi: 10.3389/fneur.2020.00782. eCollection 
      2020.