ABSTRACT
A 14-year-old girl was diagnosed with macrophage activation syndrome, based on clinical presentation, laboratory tests, and bone marrow aspirate findings. She developed severe central nervous system involvement in the form of seizure disorder and severe diffuse occlusive cerebral vasculopathy, with extensive collateral circulation consistent with moyamoya disease. To our knowledge, this description is the first of these findings in association with macrophage activation syndrome.
Subject(s)
Cerebrovascular Disorders/complications , Macrophage Activation Syndrome/complications , Adolescent , Bone Marrow/pathology , Brain/blood supply , Brain/pathology , Cerebral Angiography , Cerebrovascular Disorders/pathology , Female , Humans , Macrophage Activation Syndrome/diagnosis , Macrophage Activation Syndrome/pathology , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Moyamoya Disease/complications , Moyamoya Disease/pathology , Seizures/complications , Seizures/pathology , Severity of Illness IndexABSTRACT
Dimethylsulfoxide (DMSO) is a solvent commonly used for the cryopreservation of autologous peripheral blood stem cells (APBSC). Side effects upon infusion of DMSO-cryopreserved APBSC mainly consist of nausea, emesis, chills, rigors, and cardiovascular events, such as bradyarrhythmia or hypotension. We report the case of a patient who received DMSO-cryopreserved APBSC after myeloablative chemotherapy for a relapsing lymphoma. The patient developed a rare reaction during the infusion manifesting as transient global amnesia. The clinical course during the reaction is described and an explanation of the possible causes is discussed. This observation underlines the need for an adequate DMSO depletion to limit neurotoxicity or other adverse manifestations.
