An extremely aggressive case of Marburg's disease treated with high dose cyclophosphamide. A case report.

Abstract

BACKGROUND:

The acute, fulminant type of Multiple Sclerosis (MS), known as Marburg Disease, has been shown to have poor response to conventional acute treatments typically used for demyelinating diseases.

METHODS:

We report a 20 y/o postpartum female who was consulted to the Neurology service given findings of subacute left sided hemiparesis, left homonymous hemianopsia and bilateral papilledema. Extensive workup, including Brain and Cervical spine MRI with and without gadolinium, blood work, CSF studies, in addition to her rapid clinical decline, were highly suggestive of the demyelinating variant of Multiple Sclerosis known as Marburg Disease. After excluding other possible diagnosis, she was treated with IV corticosteroids and plasma exchange therapy with poor response. She was then started on monthly high dose cyclophosphamide therapy.

RESULTS:

Clinical and radiological improvement was present with initiation of cyclophosphamide therapy in this refractory variant of MS.

CONCLUSION:

Our findings suggest that cyclophosphamide may be a therapeutic alternative to induce clinical and radiological improvement in Marburg Disease.

• Authors: Jose Avila-Ornelas, Eduardo Labat, Gishlaine Alfonso, Carmen Serrano, Franchesca Fiorito
• Journal: Multiple sclerosis and related disorders (Mult Scler Relat Disord) Vol. 31 Pg. 51-53 (Jun 2019) ISSN: 2211-0356 [Electronic] Netherlands
• PMID: 30925320 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Chemical References

• Immunosuppressive Agents
• Cyclophosphamide

Topics

• Adult
• Brain (pathology)
• Cyclophosphamide (therapeutic use)
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Multiple Sclerosis (diagnosis, drug therapy, pathology)
• Plasma Exchange
• Treatment Outcome
• Young Adult