Shindo Akihiro, Hirata Yoshinori, Tomimoto Hidekazu
Department of Neurology, Mie University Graduate School of Medicine, Japan.
Intern Med. 2025 May 15. doi: 10.2169/internalmedicine.5198-24.
Background Amyloid-related imaging abnormalities (ARIAs), including edema/effusion (ARIA-E) and hemosiderin deposition (ARIA-H), are complications of anti-amyloid β (Aβ) monoclonal antibody therapy for Alzheimer's disease (AD). Case Presentation A Japanese woman in her 70s with mild cognitive impairment due to AD, confirmed by positive amyloid positron emission tomography, developed a new lobar cerebral microbleed (CMB) after participating in aducanumab clinical trials. Magnetic resonance imaging revealed juxtacortical white matter hyperintensities on fluid-attenuated inversion recovery, which were later resolved as a novel CMB. Conclusions Juxtacortical white matter hyperintensities may precede ARIA-H and may suggest cerebral amyloid angiopathy-related changes during anti-Aβ therapy. Monitoring of these lesions is essential.
淀粉样蛋白相关成像异常（ARIAs），包括水肿/渗出（ARIA-E）和含铁血黄素沉积（ARIA-H），是用于治疗阿尔茨海默病（AD）的抗淀粉样β（Aβ）单克隆抗体治疗的并发症。病例报告：一名70多岁的日本女性，因AD导致轻度认知障碍，经淀粉样蛋白正电子发射断层扫描阳性确诊，在参加阿杜卡单抗临床试验后出现了新的脑叶脑微出血（CMB）。磁共振成像显示在液体衰减反转恢复序列上皮质旁白质高信号，随后这些高信号消退成为一个新的CMB。结论：皮质旁白质高信号可能先于ARIA-H出现，并且可能提示抗Aβ治疗期间与脑淀粉样血管病相关的变化。对这些病变进行监测至关重要。
