CHRONIC LYMPHOCYTIC INFLAMMATION WITH PONTINE PERIVASCULAR ENHANCEMENT RESPONSIVE TO STEROIDS (CLIPPERS SYNDROME)-CASE REPORT OF A RARE DISORDER

Waseem Mehmood Nizamani, Ameet Kumar Jesrani, Mujtaba khan, Kalthoum Tlili, Nader Al Khuraish, Majid Shaikh

Abstract


ABSTRACT:

It is an uncommon central nervous system inflammatory syndrome characterized by infiltration of the brain by inflammatory cells. It is predominantly affecting the pons, with characteristic punctuate and curvilinear regions of post contrast enhancement on MRI. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) was first described in 2010 by Pittock and colleagues. The patient described here is a 57-year-old man with no co morbid presented with ataxia, diplopia, hearing and taste disturbances. His GCS was significantly decreased so that the patient required intubation and was admitted in intensive care unit. Other accompanying symptoms of seizures and central pyrexia seen, which has not been previously described in case reports of CLIPPERS. The patient had a good outcome with intravenous glucocorticosteroids. The importance of recognition of atypical radiological findings and rapid treatment cannot be overemphasized in improving patient’s long-term outcomes. Early recognition on MRI and radiological follow up are also important to optimize the treatment.

 

KEYWORDS: Chronic Lymphocytic Inflammation, Pontine Perivascular Enhancement, Steroids, Clipper syndrome


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References


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