Hypereosinophilic syndrome with central nervous system involvement treated with anti-IL-5 therapy.
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| Abstract |
Hypereosinophilic syndrome (HES) is a rare disorder characterized by a persistent eosinophilia with a multi-organ involvement including neurological manifestation. A 59-year-old man was referred from a neurosurgery unit with a spastic triparesis with predominant left side involvement, dissociated sensory loss to Th7, and metastasis-like lesions in a brain CT. MRI examination of the thoracic spine revealed an intraspinal T2-hyperintensive lesion with a subtle central gadolinium enhancement at Th4-Th8 level. MRI of the cervical spine showed a C1-Th1 long T2-hyperintensive lesion with a partial gadolinium enhancement and MRI of the brain revealed a large tumefactive T2-hyperintensive lesion in the right hemisphere. Blood tests showed an increased number of eosinophils (1790 cells/µl; 18.3%). Common causes of the eosinophilia were excluded. After corticosteroid treatment moderate neurological improvement was observed however in the brain MRI new T2-hyperintensive lesions were revealed. The patient was referred to the Department of Allergology and qualified for a treatment with mepolizumab, a monoclonal antibody against IL-5, with subsequent clinical and radiological improvement. To the best of our knowledge, this is the first case of hypereosinophilic syndrome with brain and spinal cord involvement treated with mepolizumab.
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| Authors | M Jonakowski, I Kuprys-Lipinska, P Lacwik, M Stasiolek, M Matysiak |
| Journal | Multiple sclerosis and related disorders (Mult Scler Relat Disord) Vol. 51 Pg. 102871 (Jun 2021) ISSN: 2211-0356 [Electronic] Netherlands |
| PMID | 33706008 (Publication Type: Case Reports, Letter) |
| Copyright | Copyright © 2021. Published by Elsevier B.V. |
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