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Leukoencephalopathy resolution after atypical mycobacterial treatment: a case report.
Oliveira, Marcos C B; Sato, Douglas Kazutoshi; Soares-Neto, Herval R; Lucato, Leandro T; Callegaro, Dagoberto; Nitrini, Ricardo; Medeiros, Raphael S S; Misu, Tatsuro; Fujihara, Kazuo; Castro, Luiz H.
Afiliação
  • Oliveira MC; Department of Neurology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. marcoscbo@hotmail.com.
  • Sato DK; Departments of Neurology, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. douglas.sato@med.tohoku.ac.jp.
  • Soares-Neto HR; Department of Neurology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. hervalneto@gmail.com.
  • Lucato LT; Institute of Radiology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. ltlucato@gmail.com.
  • Callegaro D; Department of Neurology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. dgcallegaro@yahoo.com.
  • Nitrini R; Department of Neurology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. rnitrini@uol.com.br.
  • Medeiros RS; Department of Pathology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. raphael.salles@gmail.com.
  • Misu T; Multiple Sclerosis Therapeutics, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. misu@med.tohoku.ac.jp.
  • Fujihara K; Multiple Sclerosis Therapeutics, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. fujikazu@med.tohoku.ac.jp.
  • Castro LH; Department of Neurology, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 5o andar, sala 5011, 05403-900, São Paulo, SP, Brazil. castrolh@usp.br.
BMC Neurol ; 15: 159, 2015 Sep 02.
Article em En | MEDLINE | ID: mdl-26329680
BACKGROUND: Association of leukoencephalopathy and atypical mycobacteriosis has been rarely reported. We present a case that is relevant for its unusual presentation and because it may shed further light on the pathogenic mechanisms underlying reversible encephalopathies. CASE REPORT: We report the case of a Hispanic 64-year-old woman with cognitive decline and extensive leukoencephalopathy. Magnetic resonance imaging revealed white-matter lesions with increased water diffusivity, without blood-brain-barrier disruption. Brain biopsy showed tissue rarefaction with vacuolation, mild inflammation, few reactive astrocytes and decreased aquaporin water-channel expression in the lesions. Six months later, she was diagnosed with atypical mycobacterial pulmonary infection. Brain lesions resolved after antimycobacterial treatment. CONCLUSION: We hypothesize leukoencephalopathic changes and vasogenic edema were associated with decreased aquaporin expression. Further studies should clarify if reversible leukoencephalopathy has a causal relationship with decreased aquaporin expression and atypical mycobacterial infection, and mechanisms underlying leukoencephalopathy resolution after antimycobacterial treatment. This article may contribute to the understanding of pathogenic mechanisms underlying magnetic resonance imaging subcortical lesions and edema, which remain incompletely understood.
Assuntos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Leucoencefalopatias / Pneumopatias / Infecções por Mycobacterium não Tuberculosas Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Female / Humans / Middle aged Idioma: En Revista: BMC Neurol Assunto da revista: NEUROLOGIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Leucoencefalopatias / Pneumopatias / Infecções por Mycobacterium não Tuberculosas Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Female / Humans / Middle aged Idioma: En Revista: BMC Neurol Assunto da revista: NEUROLOGIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil