PMID- 34475981
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231103
IS  - 1792-1015 (Electronic)
IS  - 1792-0981 (Print)
IS  - 1792-0981 (Linking)
VI  - 22
IP  - 4
DP  - 2021 Oct
TI  - CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement 
      responsive to steroids: A challenge in neurological practice, clinical landmarks 
      (Review).
PG  - 1191
LID - 10.3892/etm.2021.10625 [doi]
LID - 1191
AB  - Chronic lymphocytic inflammation with pontine perivascular enhancement responsive 
      to steroids (CLIPPERS) is a relatively newly discovered and characterized 
      condition affecting the central nervous system (CNS) that involves the brainstem 
      almost ubiquitously and that focuses primarily on the pons. Characteristically, 
      CLIPPERS represents a combination of clinical symptoms related to the pathology 
      of the brainstem in particular and has a characteristic appearance on magnetic 
      resonance imaging (MRI), with punctate and curvilinear gadolinium enhancement 
      'peppering' the pons. The lesions can be viewed via neuroimaging with a 
      predominance in the pons and adjacent rhombencephalic structures, such as the 
      cerebellar peduncles, cerebellum, medulla, and middle brain. These lesions may 
      also spread and appear in other areas of the brain such as the thalamus or white 
      matter. As the name suggests, this clinical syndrome responds to 
      immunosuppressive treatment based on glucocorticosteroids (GCSs), expressed as 
      both clinical and radiological improvements. Support for this treatment is 
      required for a long period, since exacerbations may occur without. Thus, the 
      diagnosis of CLIPPERS has garnered increased attention from clinicians and the 
      active exclusion of differential alternative diagnoses is needed. A specific 
      biomarker of serum or cerebrospinal fluid (CSF) for this condition has not been 
      discovered. The pathophysiology of this condition is not fully elucidated, and it 
      is not yet clear whether CLIPPERS is a disease in its own right or is the 
      culmination of several already known syndromes. Clinicians and radiologists 
      should pay close attention to this condition as it is relatively easy to treat 
      and patients can benefit from the early introduction of GCSs, which can produce 
      significant results through long-term immunosuppression. Taking into account 
      previous reports in the literature, which currently include over 50 cases 
      reported as CLIPPERS, this analysis addressed the clinical features, and 
      paraclinical and differential diagnoses of cases described in the literature.
CI  - Copyright (c) 2020, Spandidos Publications.
FAU - Axelerad, Any Docu
AU  - Axelerad AD
AD  - Department of Neurology, Faculty of General Medicine, 'Ovidius' University of 
      Constanta, 900470 Constanta, Romania.
AD  - Neurology Department, County Emergency Clinical Hospital 'Sf. Apostol Andrei', 
      900591 Constanta, Romania.
FAU - Stroe, Alina Zorina
AU  - Stroe AZ
AD  - Department of Neurology, Faculty of General Medicine, 'Ovidius' University of 
      Constanta, 900470 Constanta, Romania.
AD  - Neurology Department, County Emergency Clinical Hospital 'Sf. Apostol Andrei', 
      900591 Constanta, Romania.
FAU - Mihai, Cristina
AU  - Mihai C
AD  - Department of Pediatrics, Faculty of General Medicine, 'Ovidius' University of 
      Constanta, 900470 Constanta, Romania.
AD  - Pediatrics Department, County Emergency Clinical Hospital 'Sf. Apostol Andrei', 
      900591 Constanta, Romania.
FAU - Frecus, Corina
AU  - Frecus C
AD  - Department of Pediatrics, Faculty of General Medicine, 'Ovidius' University of 
      Constanta, 900470 Constanta, Romania.
AD  - Pediatrics Department, County Emergency Clinical Hospital 'Sf. Apostol Andrei', 
      900591 Constanta, Romania.
FAU - Jianu, Dragos Catalin
AU  - Jianu DC
AD  - Department of Neurology, 'Victor Babes' University of Medicine and Pharmacy of 
      Timisoara, 300041 Timisoara, Romania.
FAU - Axelerad, Daniel Docu
AU  - Axelerad DD
AD  - Department of Kinetotherapy, 'Brainaxy Clinic', 900628 Constanta, Romania.
FAU - Gogu, Anca Elena
AU  - Gogu AE
AD  - Department of Neurology, 'Victor Babes' University of Medicine and Pharmacy of 
      Timisoara, 300041 Timisoara, Romania.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210817
PL  - Greece
TA  - Exp Ther Med
JT  - Experimental and therapeutic medicine
JID - 101531947
PMC - PMC8406757
OTO - NOTNLM
OT  - CLIPPERS
OT  - central nervous system
OT  - chronic lymphocytic inflammation
OT  - pontine perivascular enhancement
OT  - responsive to steroids
COIS- The authors declare that they have no competing interests.
EDAT- 2021/09/04 06:00
MHDA- 2021/09/04 06:01
PMCR- 2021/08/17
CRDT- 2021/09/03 06:49
PHST- 2021/06/14 00:00 [received]
PHST- 2021/07/14 00:00 [accepted]
PHST- 2021/09/03 06:49 [entrez]
PHST- 2021/09/04 06:00 [pubmed]
PHST- 2021/09/04 06:01 [medline]
PHST- 2021/08/17 00:00 [pmc-release]
AID - ETM-0-0-10625 [pii]
AID - 10.3892/etm.2021.10625 [doi]
PST - ppublish
SO  - Exp Ther Med. 2021 Oct;22(4):1191. doi: 10.3892/etm.2021.10625. Epub 2021 Aug 17.