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Perrone CM, Lisak RP, Meltzer EI, Sguigna P, Tizazu E, Jacobs D, Melamed E, Lucas A, Freeman L, Pardo G, Goodman A, Fox EJ, Costello K, Parsons MS, Zamvil SS, Frohman EM, Frohman TC. Cataclysmically disseminating neurologic presentation in an immunosuppressed lupus patient: From the National Multiple Sclerosis Society Case Conference Proceedings. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2019; 6:e582. [PMID: 31355318 PMCID: PMC6624090 DOI: 10.1212/nxi.0000000000000582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Christopher M Perrone
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Robert P Lisak
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Ethan I Meltzer
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Peter Sguigna
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Etsegenet Tizazu
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Dina Jacobs
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Esther Melamed
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Ashlea Lucas
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Leorah Freeman
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Gabriel Pardo
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Andrew Goodman
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Edward J Fox
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Kathleen Costello
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Matthew S Parsons
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Scott S Zamvil
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Elliot M Frohman
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
| | - Teresa C Frohman
- Hospital of the University of Pennsylvania (C.M.P., E.T., D.J., ), Philadelphia, PA; Department of Neurology (R.P.L.), Wayne State University, Detroit, MI; Department of Neurology (E. I. Meltzer, E. Melamed, A.L., L.F., E.J.F.), Dell Medical School at the University of Texas at Austin, TX; Department of Neurology (P.S.), MS Fellowship Training Program, UT Southwestern School of Medicine, Dallas, TX; Oklahoma Medical Research Foundation (G.P.), Oklahoma City, OK; Department of Neurology (A.G.), University of Rochester, NY; Central Texas Neurology Consultants, and Department of Neurology (E.J.F.), Dell Medical School at the University of Texas at Austin, TX; The National Multiple Sclerosis Society (K.C.), New York, NY; Yerkes National Primate Research Center (M.S.P.), Emory University, Atlanta, GA; Department of Neurology and Program in Immunology (S.S.Z.), University of California San Francisco, San Francisco, CA; and Departments of Neurology and Ophthalmology (E.M.F., T.C.F.), Dell Medical School at the University of Texas at Austin, TX
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