A Bing-Neel syndrome case


INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, vol.9, no.11, pp.22660-22663, 2016 (SCI-Expanded) identifier identifier


Bing-Neel syndrome (BNS) is an extremely rare neurologic complication of WM. Herein, we aimed to report a BNS case. A 57 years old women admitted to hospital with fever, weight loss and cough in November 2009. Complete blood count was resulted as hemoglobin 7.4 gr/dl, white blood cell 1.8 x 10(3)/dl, thrombocyte 216 x 10(3)/dl. Kidney and liver function tests were in normal range. Anemia parameters were compatible with chronic disease anemia. In serum protein electrophoresis monoclonal IgM kappa pike was observed. Abdominal computerized tomography (CT) revealed splenomegaly. Bone marrow investigation was resulted as, CD20+B cell lymphoproliferative disease. Therefore she was diagnosed as WM and R-CHOP chemotherapy regimen was started. A total of 8 R-CHOP treatment was given and the patient's disease was kept under control. In April 2015, weakness in patient's right hand has begun. Then she admitted to hospital. Neurological examination revealed weakness in right extremities, right hemi-hypoesthesia, dissymmetry, dysdiadokinesia. Cranial CT has revealed focal hypo density that lye from left thalamus inferior to internal capsule. Cranial magnetic resonance images of the patient were reported as, secondary leukemic infiltration of WM. She was diagnosed as BNS. BNS is characterized with central nervous system involvement by neoplastic lymphoplasmacytoid and plasma cells. To conclude, in a WM patient if neurological symptoms appear, the possibility of BNS should be kept in mind.