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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | Balo Concentric Sclerosis | 4A0 Case 4 History
Case 4 History ---- The patient was a 42-year-old male with complicated history of rapidly progressive neurologic deterioration. Imaging studies demonstrated bi-hemispheric abnormalities. He was treated for presumptive diagnosis of tumefactive multiple sclerosis with Solumedrol, plasmapheresis, and cyclophosphamide but showed no improvement. The initial brain biopsy showed features consistent with a “macrophage-rich lesion,” although it was unclear whether the biopsy was representative. In the intensive care unit, the patient developed septic shock with fevers up to 106 oF, and he was managed with pressors and broad-spectrum antibiotics and passed away.
