An extremely aggressive case of Marburg's disease treated with high dose cyclophosphamide. A case report.

BACKGROUND

The acute, fulminant type of Multiple Sclerosis (MS), known as Marburg Disease, has been shown to have poor response to conventional acute treatments typically used for demyelinating diseases.

METHODS

We report a 20 y/o postpartum female who was consulted to the Neurology service given findings of subacute left sided hemiparesis, left homonymous hemianopsia and bilateral papilledema. Extensive workup, including Brain and Cervical spine MRI with and without gadolinium, blood work, CSF studies, in addition to her rapid clinical decline, were highly suggestive of the demyelinating variant of Multiple Sclerosis known as Marburg Disease. After excluding other possible diagnosis, she was treated with IV corticosteroids and plasma exchange therapy with poor response. She was then started on monthly high dose cyclophosphamide therapy.

RESULTS

Clinical and radiological improvement was present with initiation of cyclophosphamide therapy in this refractory variant of MS.

CONCLUSION

Our findings suggest that cyclophosphamide may be a therapeutic alternative to induce clinical and radiological improvement in Marburg Disease.