Servicio de Neurología, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital 278, Guadalajara, Jalisco 44280, México.
Department of Radiology, Hospital Civil de Guadalajara "Fray Antonio Alcalde", México.
Mult Scler Relat Disord. 2018 Oct;25:265-267. doi: 10.1016/j.msard.2018.07.048. Epub 2018 Aug 8.
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) was recently described in 2010, therefore the long-term prognosis is uncertain and there is no consensus on which steroid-sparing treatment is the most indicated. We present a case of CLIPPERS successfully treated with leflunomide.
A 43-year-old man with progressive symptoms of pontocerebellar dysfunction and radiological findings consistent with CLIPPERS was admitted to our clinic and treated with steroids in the acute phase, then he continue leflunomide for one year, showing sustained clinical and radiological remission. The treatment was changed to azathioprine and continued two more years in remission.
As far as we have documented, this is the first case of CLIPPERS kept under control with leflunomide in the medium-term with a good relative prognosis.
慢性淋巴细胞性炎症伴桥脑旁血管周围强化对类固醇有反应（CLIPPERS）于 2010 年被首次描述，因此长期预后尚不确定，对于哪种类固醇保留治疗最适用尚无共识。我们报告了一例成功用来氟米特治疗的 CLIPPERS 病例。
一名 43 岁男性，出现进行性桥脑小脑功能障碍症状和符合 CLIPPERS 的影像学发现，被收入我院。在急性期接受类固醇治疗，然后继续使用来氟米特治疗一年，表现出持续的临床和影像学缓解。治疗改为硫唑嘌呤，并继续缓解两年。
据我们所知，这是首例使用来氟米特在中期控制 CLIPPERS 的病例，具有良好的相对预后。
