Pontocerebellar inflammation and pancytopenia

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dc.contributor.authorDudley, Alexen
dc.contributor.authorO'Shea, Dervilleen
dc.contributor.authorFanning, Noelen
dc.contributor.authorBermingham, Niamhen
dc.contributor.authorSweeney, Brianen
dc.contributor.authorCronin, Simonen
dc.date.accessioned2025-01-21T14:05:25Z
dc.date.available2025-01-21T14:05:25Z
dc.date.issued2025-01-07en
dc.description.abstractCase presentation A 19-year-old woman had a 1-week history of gradual onset headache, vomiting, double vision and unsteadiness. She had been previously well. She had no sick contacts and her last foreign travel had been to Nepal over 5 years before. She was febrile at 38.4°C but systemic examination was otherwise normal. She had an ataxic gait, left sixth and seventh cranial nerve palsies, brisk lower limb reflexes and right ankle clonus. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis with 24 cells/µL (≤5), protein was raised to 1.01 g/L (0.15–0.45) and glucose was 3.0 mmol/L (plasma 5.1). Viral and bacterial tests, including TB stains and culture, were negative. There were no oligoclonal bands. Routine bloods, inflammatory markers, infective serology, vasculitis screen and serum angiotensin-converting enzyme (ACE) were normal. MR scan of brain showed extensive leptomeningeal enhancement; as well as patchy white matter signal abnormality and curvilinear enhancement mainly affecting the pons and cerebellum but also in the right frontal lobe (figure 1). MR scan of spine showed a short segment of right-sided T2 high signal and patchy enhancement in the thoracic cord.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDudley, A., O'Shea, D., Fanning, N., Bermingham, N., Sweeney, B. and Cronin, S. (2025) 'Pontocerebellar inflammation and pancytopenia', Practical Neurology. https://doi.org/10.1136/pn-2024-004405en
dc.identifier.doihttps://doi.org/10.1136/pn-2024-004405en
dc.identifier.eissn1474-7766en
dc.identifier.issn1474-7758en
dc.identifier.journaltitlePractical Neurologyen
dc.identifier.urihttps://hdl.handle.net/10468/16862
dc.language.isoenen
dc.publisherBMJ Groupen
dc.relation.ispartofPractical Neurologyen
dc.rights© 2025, the Authors (or their employer(s)). No commercial re-use. Published by BMJ Group.en
dc.subjectHaemophagocytic lymphohistiocytosis (HLH)en
dc.subjectCNS neuroinflammatory syndromeen
dc.subjectFamilial HLHen
dc.subjectNeurosarcoidosisen
dc.subjectCLIPPERSen
dc.titlePontocerebellar inflammation and pancytopeniaen
dc.typeArticle (peer-reviewed)en
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