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CLIPPERS syndrome responsive to Leflunomide: A case report
Parada-Garza Juan Didier1, Miranda-García Luis Adrián1, Salvatella-Gutierrez Ana Paola1
1Servicio de Neurología, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital 278, Guadalajara, Jalisco 44280, México.
Multiple Sclerosis and Related Disorders
|August 28, 2018
Summary
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) can be effectively managed with leflunomide. This case study shows sustained remission in CLIPPERS patients treated with leflunomide and azathioprine.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) is a recently described neurological condition.
- The long-term prognosis and optimal steroid-sparing treatments for CLIPPERS remain uncertain.
- Current treatment strategies lack consensus, necessitating exploration of alternative therapies.
Observation:
- A 43-year-old male presented with progressive pontocerebellar dysfunction and characteristic CLIPPERS radiological findings.
- The patient received initial steroid treatment for the acute phase of the condition.
- Leflunomide was administered for one year, leading to sustained clinical and radiological remission.
Findings:
- This report details the first documented case of CLIPPERS successfully managed with leflunomide.
- Sustained medium-term remission was achieved with leflunomide treatment.
- Subsequent treatment with azathioprine for two years maintained remission, indicating a favorable prognosis.
Implications:
- Leflunomide represents a potential steroid-sparing therapeutic option for CLIPPERS.
- This case suggests leflunomide may offer a good relative prognosis for CLIPPERS patients.
- Further research into leflunomide's efficacy and long-term outcomes in CLIPPERS is warranted.
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