Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Alzheimers Dement. 2024 Nov;20(11):8192-8197. doi: 10.1002/alz.14223. Epub 2024 Aug 30.
Anti-amyloid antibody therapies such as lecanemab are increasingly being used to treat Alzheimer's disease (AD). These therapies are associated with a high rate of amyloid-related imaging abnormalities (ARIA).
We review the case history of a patient who developed ARIA associated with lecanemab treatment.
In addition to microhemorrhages and cerebral edema that are recognized features of ARIA, the patient developed several ischemic strokes. The patient also experienced frequent electrographic seizures without overt clinical seizures. The patient demonstrated clinical and radiographic improvement after steroid treatment.
Our case suggests that ischemic strokes may be a feature of ARIA and highlights the importance of having a high clinical suspicion for seizures in ARIA. As anti-amyloid therapies are likely going to be increasingly used to treat AD, it is important to appreciate the spectrum of clinical and radiographic findings that can result as side effects from this class of therapies.
We report a patient who developed severe amyloid-related imaging abnormalities (ARIA) after treatment with lecanemab. Our report suggests that ischemic strokes may be a novel imaging feature of ARIA. Our report highlights the need for high clinical suspicion for seizures in ARIA.
抗淀粉样蛋白抗体疗法，如 lecanemab，越来越多地被用于治疗阿尔茨海默病（AD）。这些疗法与淀粉样蛋白相关的成像异常（ARIA）的发生率很高。
我们回顾了一位接受 lecanemab 治疗后发生 ARIA 的患者的病史。
除了 ARIA 公认的特征，如微出血和脑水肿外，该患者还发生了几次缺血性中风。该患者还经历了频繁的脑电图痫性发作，而没有明显的临床痫性发作。该患者在类固醇治疗后表现出临床和影像学改善。
我们的病例表明，缺血性中风可能是 ARIA 的一个特征，并强调了在 ARIA 中对癫痫发作保持高度临床怀疑的重要性。随着抗淀粉样蛋白疗法可能越来越多地用于治疗 AD，了解此类疗法可能产生的一系列临床和影像学结果非常重要。
我们报告了一例接受 lecanemab 治疗后发生严重淀粉样蛋白相关成像异常（ARIA）的患者。我们的报告表明，缺血性中风可能是 ARIA 的一种新的影像学特征。我们的报告强调了在 ARIA 中对癫痫发作保持高度临床怀疑的必要性。
