Ataxia Following Allogenic Stem Cell Transplantation: No Stone Unturned

C. Maurice, Austin M. Pereira, Warren P. Mason
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Abstract

A thirty-one year-old Sri Lankan man presented with a two-month history of progressive pan-cerebellar syndrome, following allogeneic stem cell transplantation. This curative-intent therapy was performed in the context of an underlying acute myeloid leukemia. During the post-transplant period, patients are extremely vulnerable, especially due to the immunologic fluctuations. Reaching equilibrium is crucial, preventing complications of both extremes of the immunologic response, such as opportunistic infections or graft versus host disease. Numerous aetiologies were considered in the differential diagnosis of this pan-cerebellar syndrome. Most of those conditions mandate a prompt management, because of their reversible or lethal nature. Our thorough investigation process was a race against time. Excluding “Red Flags” remains the priority. Mindfulness and time will eventually lead to the proper diagnosis. We discuss our structured investigation process emphasizing on the key element: a “Systematic Approach”.
同种异体干细胞移植后的共济失调:无坚不摧
一名31岁的斯里兰卡男子在异基因干细胞移植后,有两个月的进行性泛小脑综合征病史。这种治疗目的性治疗是在潜在急性髓系白血病的背景下进行的。在移植后的时期,患者非常脆弱,尤其是由于免疫波动。达到平衡至关重要,可以预防免疫反应的两种极端并发症,如机会性感染或移植物抗宿主病。在这种泛小脑综合征的鉴别诊断中,考虑了许多病因。由于这些情况具有可逆性或致命性,大多数情况都要求立即进行管理。我们的彻底调查过程是在与时间赛跑。排除“危险信号”仍然是优先事项。正念和时间最终会导致正确的诊断。我们讨论了我们的结构化调查过程,强调关键要素:“系统方法”。
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