Leptomeningeal gliomatosis with high levels of adenosine deaminase in the cerebrospinal fluid

  • Nishihara Hideaki
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
  • Omoto Masatoshi
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
  • Ogasawara Jun-ichi
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
  • Koga Michiaki
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
  • Kawai Motoharu
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
  • Kanda Takashi
    Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine

Bibliographic Information

Other Title
  • 脳脊髄液adenosine deaminase(ADA)が高値を呈した星状細胞腫による髄膜膠腫症の61歳男性例
  • 症例報告 脳脊髄液adenosine deaminase(ADA)が高値を呈した星状細胞腫による髄膜膠腫症の61歳男性例
  • ショウレイ ホウコク ノウ セキズイエキ adenosine deaminase(ADA)ガ タカネ オ テイシタ ホシジョウ サイボウ シュ ニ ヨル ズイマクコウシュショウ ノ 61サイ ダンセイレイ

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Description

A 61-year-old man developed disturbance of consciousness for 2 weeks. He showed neck stiffness and hyporeflexia. Analysis of his cerebrospinal fluid (CSF) revealed pleocytosis and markedly reduced glucose contents. Adenosine deaminase (ADA) levels in the CSF were elevated (28.8 IU/l). Brain magnetic resonance imagings showed enhancement of the leptomeninges. Tuberculous meningitis was considered, but antituberculous drug was not effective. Repeated cytological analysis of the CSF demonstrated atypical cells with enlarged unevenly distributed nuclei and immunoreactive with glial fibrillary acidic protein. We diagnosed him as leptomeningeal gliomatosis. CSF ADA may be elevated in this rare disorder, and here we emphasize that repeated cytological analysis with immunohistochemical staining was useful for diagnosis.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 54 (4), 308-312, 2014

    Societas Neurologica Japonica

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