Title |
Leukoencephalopathy resolution after atypical mycobacterial treatment: a case report
|
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Published in |
BMC Neurology, September 2015
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DOI | 10.1186/s12883-015-0415-0 |
Pubmed ID | |
Authors |
Marcos C. B. Oliveira, Douglas Kazutoshi Sato, Herval R. Soares-Neto, Leandro T. Lucato, Dagoberto Callegaro, Ricardo Nitrini, Raphael S. S. Medeiros, Tatsuro Misu, Kazuo Fujihara, Luiz H. Castro |
Abstract |
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. 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. 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. |
X Demographics
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 5 | 17% |
Professor | 4 | 13% |
Student > Postgraduate | 4 | 13% |
Student > Doctoral Student | 3 | 10% |
Researcher | 3 | 10% |
Other | 6 | 20% |
Unknown | 5 | 17% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 9 | 30% |
Biochemistry, Genetics and Molecular Biology | 5 | 17% |
Neuroscience | 4 | 13% |
Immunology and Microbiology | 2 | 7% |
Nursing and Health Professions | 1 | 3% |
Other | 4 | 13% |
Unknown | 5 | 17% |