No abstract

Central nervous system methotrexate-associated lymphoproliferative disorder (CNS-MTX-LPD) is rare, but its spontaneous regression has been observed in some patients after withdrawal of agents. We herein report three cases of primary CNS-MTX-LPD that received oral MTX for rheumatoid arthritis. Epstein-Barr virus and oligoclonal bands (OCBs) were positive, while proton magnetic resonance spectroscopy ( 1 H-MRS) showed an elevated lipid peak and slightly elevated choline/N-acetylaspartate ratio in common. After MTX withdrawal, brain lesions showed spontaneous regression in all cases. Our patient's 1 H-MRS findings and OCBs may reflect a non-monoclonal lymphoproliferative histology as benign-type lesions in CNS-MTX-LPD.

Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a novel autoimmune meningoencephalomyelitis. 1 GFAP-IgG in the cerebrospinal fluid is positive and typically responds well to steroid therapy. However, the pathogenic role of anti-GFAP antibody remains unclear, 2 and there is limited consensus regarding treatment for cases with tumor complications. We experienced three cases of autoimmune GFAP astrocytopathy in our hospital. One of them was a young woman who received ovarian teratoma excision, whereas the remaining two showed characteristic clinical and imaging findings.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated neuropathy, but its risk factors are still unclear. 1 Gender dysphoria is a mismatch between physical sex and psychological gender identity. Gender-affirming surgeries and hormone therapies are currently increasing, but long-term outcomes of these therapies are largely understudied. 2 Although both CIDP and gender dysphoria can severely affect the quality of life, little is known about their relationship. We report on a case of a CIDP patient with gender dysphoria.