Successful treatment of dermato-neuro syndrome with plasmapheresis

BMJ Case Rep. 2020 Dec 29;13(12):e237170. doi: 10.1136/bcr-2020-237170.

Abstract

Altered mental status can have many causes ranging from emergent intracranial pathologies to more insidious, systemic toxic aetiologies. We report a rare case of dermato-neuro syndrome in a 71-year-old man with a known history of scleromyxoedema. The patient initially presented with encephalopathy which quickly progressed to generalised tonic-clonic seizures and coma. While his presentation fits with other, although rare, cases of dermato-neuro syndrome, it is imperative to rule out lethal, more common causes of altered mentation. Due to the rarity and difficulty in diagnosis of dermato-neuro syndrome, there is a significant debate regarding the optimal management as there are no standardised treatment protocols. In our case, the patient was successfully treated with plasmapheresis resulting in improved neurologic function.

Keywords: adult intensive care; coma and raised intracranial pressure; dermatology; haematology (incl blood transfusion).

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain Diseases / diagnosis
  • Brain Diseases / etiology
  • Clinical Deterioration
  • Coma* / diagnosis
  • Coma* / etiology
  • Coma* / therapy
  • Diagnosis, Differential
  • Humans
  • Male
  • Neurologic Examination / methods
  • Patient Care Management / methods
  • Plasmapheresis / methods*
  • Respiration, Artificial / methods
  • Scleromyxedema* / complications
  • Scleromyxedema* / physiopathology
  • Seizures* / diagnosis
  • Seizures* / etiology
  • Seizures* / therapy
  • Syndrome
  • Treatment Outcome