Averchenkov D M, Bejsheeva M T, Ivakina E D, Fominykh V V, Grazhdantseva L Yu, Ivashchenko R A, Arzumanian N Sh, Brylev L V, Guekht A B
Bujanov Moscow City Clinical Hospital, Moscow, Russia.
Bujanov Moscow City Clinical Hospital, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(12):106-114. doi: 10.17116/jnevro2019119121106.
Levamisole is an immunomodulatory drug which can trigger development of levamisole-induced multifocal inflammatory leukoencephalopathy (LIMIL) in patients treated for helminthic invasion, aphthous stomatitis, cancer, or cocaine users. LIMIL clinical case in patient 45 years old after single dose of levamisole (taken without any medical prescription) was described. We presented clinical history and clinical picture, MRI and laboratory data and treatment results during 1-year observation. According to similarity of LIMIL with acute disseminating encephalomyelitis or debut of multiple sclerosis and high frequency of levamisole usage in Russia (usually without medical prescription) LIMIL should be included in differential diagnosis in demyelinating disorders and treated according to current clinical recommendation.
左旋咪唑是一种免疫调节药物，可在接受蠕虫感染、复发性口疮性口炎、癌症治疗的患者或可卡因使用者中引发左旋咪唑诱导的多灶性炎症性白质脑病（LIMIL）。描述了一名45岁患者在单次服用左旋咪唑（无任何医嘱）后发生LIMIL的临床病例。我们呈现了临床病史、临床表现、磁共振成像（MRI）和实验室数据以及1年观察期内的治疗结果。鉴于LIMIL与急性播散性脑脊髓炎或多发性硬化症初发症状的相似性，以及左旋咪唑在俄罗斯的高使用频率（通常无医嘱），LIMIL应纳入脱髓鞘疾病的鉴别诊断，并根据当前临床建议进行治疗。
