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Paggi R, Mariotti F, Mencarini J, Bresci S, Campolmi I, Bartalesi F, Borchi B, Nassi L, Sordi B, Vannucchi AM, Bartoloni A. Orbital Infiltration in a Patient with Waldenström Macroglobulinemia: Need for Multidisciplinary Approach and Comparison with the Literature. Mediterr J Hematol Infect Dis 2023; 15:e2023028. [PMID: 37180207 PMCID: PMC10171213 DOI: 10.4084/mjhid.2023.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
The use of specific inhibitory drugs of intracellular signalling pathways (such as Bruton-Kinase inhibitors) for the treatment of Waldenström's macroglobulinaemia (WM) is a recognised risk factor for Aspergillus spp. infections. The overlapping clinical manifestations of the two diseases may require the involvement of different medical specialities. We describe the clinical course of a patient with pulmonary and encephalic aspergillosis, with concomitant orbital infiltration, which represented a difficult diagnosis: the case required a multidisciplinary approach to define the ocular lesions and an in-depth study of the literature.
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Affiliation(s)
- Riccardo Paggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Mariotti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Jessica Mencarini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Silvia Bresci
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Irene Campolmi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Filippo Bartalesi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Luca Nassi
- Hematology Unit, Careggi University Hospital, Florence, Italy
| | - Benedetta Sordi
- Hematology Unit, Careggi University Hospital, Florence, Italy
- Center for Innovation and Research in Myeloproliferative Neoplasms, Hematology Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Alessandro Maria Vannucchi
- Center for Innovation and Research in Myeloproliferative Neoplasms, Hematology Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
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Mungmunpuntipantip R, Wiwanitkit V. Ramsay Hunt syndrome and mRNA SARS-COV-2 vaccination. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:48. [PMID: 34991852 PMCID: PMC8721891 DOI: 10.1016/j.eimce.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
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Mungmunpuntipantip R, Wiwanitkit V. Ramsay Hunt syndrome and mRNA SARS-COV-2 vaccination. Enferm Infecc Microbiol Clin 2021; 40:48. [PMID: 34462613 PMCID: PMC8387215 DOI: 10.1016/j.eimc.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kuang Q, Yu J, Zhang X, Yang F, Chen X, Xiao W, Fan Y, Wang Y. Trochlear nerve damage resulting from Waldenstrom's macroglobulinemia: A case report and literature review. Rev Neurol (Paris) 2020; 177:317-319. [PMID: 32807406 DOI: 10.1016/j.neurol.2020.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Qing Kuang
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China.
| | - Juming Yu
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Xiaodong Zhang
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Fei Yang
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Xiaoling Chen
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Wei Xiao
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Yang Fan
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
| | - Yirong Wang
- Affiliated Hospital of North Sichuan Medical College Nanchong, 637000 Sichuan, China
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Imaging spectrum of Bing–Neel syndrome: how can a radiologist recognise this rare neurological complication of Waldenström’s macroglobulinemia? Eur Radiol 2018; 29:102-114. [DOI: 10.1007/s00330-018-5543-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/22/2018] [Accepted: 05/16/2018] [Indexed: 12/19/2022]
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Torrealba-Acosta G, Gadhia R, Leslie-Mazwi T. A rare neurological complication of Waldenstrom's Macroglobulinemia. J Clin Neurosci 2017; 48:143-146. [PMID: 29113857 DOI: 10.1016/j.jocn.2017.10.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
Bilateral and simultaneous facial nerve palsy (FNP) is a rare clinical condition occurring in 0.3-2.0% of facial palsy cases and is typically a manifestation of an underlying systemic disease. We here describe a case of a 67-year-old Hispanic man with a known history of Waldenstrom's Macroglobulinemia (WM) who presented to the clinic with a sub-acute onset of bilateral facial weakness. No alternate etiology for the facial weakness was identified after a thorough diagnostic approach. WM is a rare hematological condition due to low-grade B cell lymphoma, where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM. Peripheral neuropathy develops in 15-30% of the cases, being usually a chronic, progressive, symmetric, predominantly distal polyneuropathy. Facial nerve impairment is unusual; however, it could be caused by anoxic damage as a result of an increased blood viscosity from IgM monoclonal gammopathy, direct nerve infiltration of tumorous cells and an antibody (anti-MAG) mediated demyelinating process. Treatment is directed to the established mechanism for neural injury. This report highlights a rare condition (WM) with a rare complication (bilateral facial nerve palsy) and illustrates the broad differential comprised by this presenting complaint.
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Affiliation(s)
| | - Rajan Gadhia
- Massachusetts General Hospital, Department of Neurology, United States
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Cuenca Hernández R, Guzman de Villoria Lebiedziejewski J, Roa Martínez E, Menarguez Diaz J. Síndrome de Bing-Neel como debut de una macroglobulinemia de Waldenström asociada a infiltración orbitaria. Neurologia 2015; 30:252-5. [DOI: 10.1016/j.nrl.2013.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 04/06/2013] [Indexed: 11/16/2022] Open
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Cuenca Hernández R, Guzman de Villoria Lebiedziejewski J, Roa Martínez E, Menarguez Diaz J. Bing-Neel syndrome as an initial sign of Waldenström macroglobulinaemia associated with orbital infiltration. NEUROLOGÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.nrleng.2013.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Optic nerve involvement of Waldenström's macroglobulinemia: with autopsy findings. Neurol Sci 2014; 35:1299-302. [PMID: 25027010 DOI: 10.1007/s10072-014-1865-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
Waldenström's macroglobulinemia (WM) is an indolent chronic lymphoproliferative disorder within the spectrum of lymphoplasmacytic lymphoma (LPL), characterized by a proliferation of plasmacytoid lymphocytes and the production of monoclonal IgM. Although, peripheral neurologic complications commonly occurs due to hyperviscosity in WM, central nervous system (CNS) involvement is very rare. Herein, we present the case of a 67-year-old man who initially presented with progressive visual loss and was diagnosed as WM/LPL with a very aggressive clinical course. He underwent chemotherapy with high dose methotrexate (MTX) plus cytarabine (Ara-C). However, he died and findings of a subsequent autopsy revealed the presence of lymphoplasmacytoid cells in the optic nerve.
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Abstract
Bing-Neel syndrome (BNS) is defined as intracranial involvement of Waldenström macroglobulinemia (WM). Few cases of orbital involvement have been reported. A 51-year-old man with a history of WM developed bilateral orbitopathy and optic neuropathy. Orbital biopsy, cerebrospinal fluid studies, and neuroimaging confirmed the diagnosis of BNS involving the orbital soft tissues, optic nerves, meninges, and cauda equina. The neuro-ophthalmic manifestations resolved after parenteral and intrathecal chemotherapy in addition to autologous stem cell transplantation. The rare neuro-ophthalmic manifestations of BNS may require a multifaceted approach to therapy.
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Bilateral ocular involvement as a presentation of Waldenström’s macroglobulinemia. Med Oncol 2010; 28:1624-5. [DOI: 10.1007/s12032-010-9648-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 08/02/2010] [Indexed: 10/19/2022]
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Baehring JM, Hochberg EP, Raje N, Ulrickson M, Hochberg FH. Neurological manifestations of Waldenström macroglobulinemia. ACTA ACUST UNITED AC 2008; 4:547-56. [DOI: 10.1038/ncpneuro0917] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 08/20/2008] [Indexed: 12/11/2022]
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