PMC9868404_01
Head magnetic resonance imaging. Diffusion-weighted imaging with MRI demonstrated isointensity (A) with an increased signal of apparent diffusion coefficient map (B) of the bilateral occipital cortex (B), indicating vasogenic edema in the regions. Fluid-attenuated inversion recovery MRI showed an increased signal intensity in the regions (C).
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F1
Bone marrow examination showed infiltration of the bone marrow by activated macrophages, compatible with the findings of MAS (Supplementary Figure 1). Diffusion-weighted imaging with MRI demonstrated isointensity (Figure 1A) with an increased signal of apparent diffusion coefficient map (Figure 1B) of the bilateral occipital cortex (Figure 1B), indicating vasogenic edema in these regions. Fluid-attenuated inversion recovery MRI showed an increased signal intensity in these regions (Figure 1C).
Clinical course.
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F2
A second methylprednisolone pulse therapy (1 g/day for 3 days) was administered, with subsequent administration of 80 mg/day prednisolone, 1,000 mg intravenous cyclophosphamide (IVCY) once, and 0.4 g/kg/day intravenous immunoglobulin (IVIg) for 5 days (Figure 2).