PMC9252288_01
Cerebrospinal fluid (CSF) analysis. Multiple lumbar punctures during hospitalization and outpatient follow-up showed initial lymphocytic pleocytosis (up to 48 cells/mul) and elevated protein (up to 261 mg/dl) which improved after discontinuation of dupilumab (dotted line; Jan 8th), followed by administration of 1g Methylprednisolone IV for 3 days (arrow; Jan 27th), and subsequent oral steroid treatment for 4 weeks.
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F1
Figure 1 shows the dynamics of his CSF parameters before and after initiation of treatment, whereas Figure 2 shows his findings on the MRI during his first hospitalization and on follow-up.
MRI imaging. The initial MRI showed nodular, T1 contrast-enhancing lesions in the right temporo-parietal lobe (indicated by arrows in the upper row) suspicious for sarcoidosis with accompanying edema in T2 (indicated by arrows in the lower row). Discontinuation of dupilumab (Jan 8th) and initiation of a treatment with steroids (Jan 27th) led to quick regression of the nodular lesions and gradual regression of the brain edema.
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F2
Figure 1 shows the dynamics of his CSF parameters before and after initiation of treatment, whereas Figure 2 shows his findings on the MRI during his first hospitalization and on follow-up.