Journal
MULTIPLE SCLEROSIS AND RELATED DISORDERS
Volume 13, Issue -, Pages 44-46Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.msard.2017.02.005
Keywords
Multiple sclerosis; Adenosine deaminase; Tuberculosis; Cerebrospinal fluid; Brain biopsy
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An 80-year-old man developed dysarthria, quadriplegia, sensory disturbance and ataxia in all limbs. Brain and spinal magnetic resonance imaging (MRI) revealed multiple enhanced lesions. Cerebrospinal fluid (CSF) levels of adenosine deaminase (ADA) remarkably elevated. Tuberculosis DNA was not detected, and tuberculosis was not cultured either in the CSF. Brain biopsy revealed the inflammatory demyelinating lesions. With the diagnosis of multiple sclerosis, corticosteroid therapy resulted in rapid improvement of his symptoms and MRI abnormalities. CSF levels of ADA also decreased. Multiple sclerosis should be included in differential diagnosis of disorders with ADA elevation in the CSF.
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