دورية أكاديمية

Dramatic Efficacy of Interferon and Vemurafenib on Psychiatric Symptoms Revealing BRAFV600E-Mutated Erdheim–Chester Disease: A Case Report

التفاصيل البيبلوغرافية
العنوان: Dramatic Efficacy of Interferon and Vemurafenib on Psychiatric Symptoms Revealing BRAFV600E-Mutated Erdheim–Chester Disease: A Case Report
المؤلفون: Razanamahery, Jérôme, Abdallahoui, Maroua, Chabridon, Guillaume, Fromont, Agnès, Tarris, Georges, Idbaih, Ahmed, Comby, Pierre Olivier, Godard, Francois, Haroche, Julien, Audia, Sylvain, Bonnotte, Bernard
المصدر: Frontiers in Immunology ; volume 13 ; ISSN 1664-3224
بيانات النشر: Frontiers Media SA
سنة النشر: 2022
المجموعة: Frontiers (Publisher - via CrossRef)
الوصف: Erdheim–Chester disease (ECD) is a rare condition with underestimated neurological involvement. Mild psychiatric symptoms such as mood swings have been rarely described in the clinical spectrum of neuro-ECD. We here describe the first patient with psychiatric manifestations of delirium revealing ECD with neurological involvement with favorable evolution under interferon followed by BRAF inhibitor monotherapy. An 81-year-old woman was referred to the hospital because of delirium and severe cognitive impairment associated with a cerebellar syndrome. Brain magnetic resonance imaging showed “FLAIR-changes” lesions in the pons and upper cerebellum peduncles. Blood and cerebrospinal fluid (CSF) analyses showed normal results except for an elevated neopterin level in the CSF. Whole-body CT scan ( 18 FDG-PET) showed peri-nephric fat infiltration and aorta adventitia sheathing with radiotracer uptake in the pons, vessels, peri-nephric fat, and bone lesions, which was characteristic of ECD. The diagnosis was confirmed on perirenal tissue biopsy, which also showed a BRAF V600E mutation. Treatment with interferon resulted in the resolution of delirium, and treatment with BRAF inhibitor subsequently resulted in a partial remission of all active sites. This case highlights that delirium can be the first manifestation of neurodegenerative ECD. ECD should be screened in unexplained psychiatric features as interferon and targeted therapy appear to be effective in this situation.
نوع الوثيقة: article in journal/newspaper
اللغة: unknown
DOI: 10.3389/fimmu.2022.918613
DOI: 10.3389/fimmu.2022.918613/full
الإتاحة: https://doi.org/10.3389/fimmu.2022.918613Test
حقوق: https://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.CF0C8E9E
قاعدة البيانات: BASE