Leukoencephalopathy in multiple myeloma: Two case reports

Lebrun, C.; Chanalet, S.; Frénay, Marc; Chatel, M

doi:10.1023/a:1008353312410

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…Monoclonal gammopathy is frequently associated with a chronic progressive sensorimotor peripheral neuropathy. In contrast, involvement of the CNS in patients with monoclonal gammopathy has only been described in case reports [13,18–20] and smaller case series [11,12]. Although these suggest that demyelination in the CNS may occur in some patients with either IgG or IgM M‐protein, it is yet uncertain whether there is a clear association between circulating M‐proteins and pathological involvement of the CNS.…”

Section: Discussionmentioning

confidence: 99%

“…The presumed target antigens are not exclusively expressed in the peripheral nervous system (PNS), but are also widely distributed in the CNS [8–11]. Generally, reports about CNS involvement in patients with monoclonal gammopathy are sparse, and previous MRI‐based studies demonstrated that only a subset of patients with monoclonal gammopathy display demyelinating lesions in the cerebral white matter [11–13]. Thus it remains largely unclear that why immunopathological effects of circulating M‐proteins, especially those with specific immunoreactivity against glycolipids, appear to be restricted to the PNS only.…”

Section: Introductionmentioning

confidence: 99%

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Central nervous system involvement in patients with monoclonal gammopathy and polyneuropathy

Lehmann

Hoffmann

Hörste

et al. 2010

Euro J of Neurology

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Our results complement previous reports that some patients with monoclonal gammopathy and polyneuropathy can develop solitary or disseminated signs of CNS involvement. It indicates that pathological effects of M-proteins are not necessarily restricted to the peripheral nervous system. The specificity and affinity of circulating M-protein to antigens in the CNS might be critical for the development of different clinical phenotypes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central nervous system involvement in patients with monoclonal gammopathy and polyneuropathy

Lehmann

Hoffmann

Hörste

et al. 2010

Euro J of Neurology

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“…These patients developed severe encephalopathy with seizures and mental status deterioration following treatment for multiple myeloma. 10 Methotrexate (used in Cases 3 and 4) has a welldocumented history of producing neurotoxic effects following administration. Within hours of a methotrexate dose, an aseptic meningitis has been shown to develop in some patients.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy-induced toxic leukoencephalopathy causes a wide range of symptoms: a series of four autopsies

2004

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We have observed an increasing number of autopsies on patients with chemotherapy-related complications. One complication is toxic leukoencephalopathy, which is due to a direct toxic effect of chemotherapeutic agents on the central nervous system white matter. Autopsies of four cases of toxic leukoencephalopathy were performed following standard protocols. The brain and spinal cord were examined routinely, and histological sections were taken for evaluation. We report here three patients with hematologic malignancies and one patient with metastatic carcinoma with chemotherapy-induced leukoencephalopathy. The first was a 56-yearold male treated with multiple chemotherapeutics for multiple myeloma. He presented with confusion and focal seizures with a rapid progression to coma and decerebrate posturing. The second was a 36-year-old male who developed mental status changes, ataxia and dysarthria following treatment for lymphoma. The third was a 16-year-old male who developed a profound peripheral and central neuropathy after chemotherapy treatment for Tcell acute lymphoblastic leukemia. The fourth was a 49-year-old female patient who was treated with multiple chemotherapeutics for Stage II breast carcinoma and subsequently developed visual acuity and field defects. The neuropathologic findings in these cases, although similar, varied in severity and distribution. The white matter was affected by severe myelin pallor, edema, and a prominent macrophage infiltrate in each of the cases. The location and extent of the central nervous system pathology correlated with the type and severity of clinical symptoms. These four cases, with their varied presenting symptoms, clinical courses, and degree of pathology, emphasize the importance of considering toxic leukoencephalopathy as an etiology of acute neurologic deterioration following high-dose chemotherapy.

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“…The association between leukoencephalopathy and multiple myeloma is extremely rare, and to our knowledge, only two similar cases have been previously reported in patients with more advanced multiple myeloma . One case presented with cognitive complaints, paresthesia, sensory ataxia, and amyotrophy; the other case presented with headache, vertigo, disorientation, and asthenia.…”

Section: Discussionmentioning

confidence: 82%

Smoldering Multiple Myeloma Associated Leukoencephalopathy Presenting with Holmes Tremor, Ataxia, and Pyramidal Syndrome

Aquino

Connolly

Lang

2018

Movement Disord Clin Pract

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Leukoencephalopathy in multiple myeloma: Two case reports

Abstract: The authors suggest that leukoencephalopathy is probably a direct cerebral expression of malignant gammopathy.

Cited by 12 publications

References 7 publications

Central nervous system involvement in patients with monoclonal gammopathy and polyneuropathy

Central nervous system involvement in patients with monoclonal gammopathy and polyneuropathy

Chemotherapy-induced toxic leukoencephalopathy causes a wide range of symptoms: a series of four autopsies

Smoldering Multiple Myeloma Associated Leukoencephalopathy Presenting with Holmes Tremor, Ataxia, and Pyramidal Syndrome

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