Departments of Neurology (A.T., T.T., M.T.H.), Neuroradiology (A.-H.P., E.H.), and Neuropathology (K.K.), University of Bonn, Germany; Department of Neuroradiology (H.U.), University of Freiburg, Germany; and German Center for Neurodegenerative Disease (M.T.H.), Bonn, Germany.
Neurol Neuroimmunol Neuroinflamm. 2015 Oct 15;2(6):e165. doi: 10.1212/NXI.0000000000000165. eCollection 2015 Dec.
To investigate whether the occurrence or clearance of microhemorrhages in cerebral amyloid angiopathy (CAA)-related vascular inflammation can be modified by immunosuppressive treatment.
Clinical and radiologic follow-up for more than 5 years of a patient with histopathologically confirmed CAA-related vascular inflammation treated with a prolonged and tapered regimen of IV cyclophosphamide and oral steroids.
Under long-term immunosuppressive treatment, a reduced number of cortical micobleeds was observed on repeat MRIs because of both the prevention of new microbleeds and the clearance of those existing at baseline.
Sustained immunosuppression should be considered and systematically investigated as a treatment option for cortical microbleeds in CAA and related inflammatory phenotypes.
This study provides Class IV evidence. This is a single observational study without controls.
研究免疫抑制治疗是否可以改变脑淀粉样血管病（CAA）相关血管炎症中的微出血的发生或清除。
对经病理证实为 CAA 相关血管炎症的患者，采用 IV 环磷酰胺和口服类固醇长期逐渐减量的方案进行了超过 5 年的临床和影像学随访。
在长期免疫抑制治疗下，由于新的微出血的预防和基线时存在的微出血的清除，重复 MRI 显示皮质微出血的数量减少。
应考虑持续免疫抑制治疗，并作为 CAA 和相关炎症表型的皮质微出血的治疗选择进行系统研究。
本研究提供了 IV 级证据。这是一项没有对照的单一观察性研究。
