A 76-year-old woman with paraplegia

A-76-year old woman was admitted to the hospital with paraplegia after a collapse at home. Magnetic resonance imaging showed white matter lesions from Th4 to L2 as well as large confluent white matter lesions in the cerebrum. Within 3 days, the patient's mental status decreased dramatically and she finally died on day 16 after her fall. Autopsy examination revealed an acute myeloid leukemia, which had not previously been diagnosed and which had never been treated. In the CNS, we found spread of myeloblasts in combination with acute demyelinating lesions which corresponded to the antibody- and complement-mediated pattern II of multiple sclerosis lesions. This case implies that association of acute myeloid leukemia and acute CNS demyelination needs to be discussed and suggests that AML patients need to be strictly monitored for CNS functions.