Stroke after initiation of interferon-beta treatment for relapsing–remitting disseminated white matter disease
Authors: Bosche, B.; Dohmen, C.1; Impekoven, P.2; Weber, O. Z.1; Reske, D.1; Rubbert, A.3; Jacobs, A. H.1; Petereit, H.-F.1
Source: Acta Neurologica Scandinavica, Volume 113, Number 6, June 2006 , pp. 433-436(4)
Publisher: Blackwell Publishing
Abstract:
Bosche B, Dohmen C, Impekoven P, Weber OZ, Reske D, Rubbert A, Jacobs AH, Petereit H-F. Stroke after initiation of interferon beta treatment for relapsing–remitting disseminated white matter disease.Acta Neurol Scand 2006: 113: 433–436.© Blackwell Munksgaard 2006. Background – Interferon-beta (INF-β) is effective and used in reducing exacerbation frequency and disease progression in multiple sclerosis. In certain circumstances, INF-β can lead to rare side effects. Aims of the study – We report the case of a 34-year-old female patient satisfying the McDonald criteria of multiple sclerosis without showing typical pathologic changes in cerebrospinal fluid (CSF). After introduction of INF-β treatment, she quickly developed further progression of her disseminated neurological symptoms and finally an ischemic cerebral infarction. Methods – Evaluation of the patient included arterial angiography, magnetic resonance and positron emission tomography, histopathological assessment as well as a broad spectrum of serum and CSF analysis. Results – All diagnostic evaluations and the clinical course revealed evidences for a primary angiitis of the CNS. We discuss the possible worsening due to inappropriate INF-β treatment in cerebral angiitis promoting severe cerebrovascular insufficiency. Conclusion – The authors suggest that all diagnostic multiple sclerosis criteria including typical CSF findings should be ascertained before INF-β treatment is initiated.Keywords: relapsing-remitting white matter disease; multiple sclerosis revised diagnostic criteria; interferon-beta; primary angiitis of the CNS; endothelium; ischemic infarction
Document Type: Research article
DOI: 10.1111/j.1600-0404.2006.00638.x
Affiliations: 1: Department of Neurology, University of Cologne, Germany 2: Department of Neuroradiology, University of Cologne, Germany 3: Department of Internal Medicine, University of Cologne, Germany

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