Marburg Multiple Sclerosis Variant: Complete Remission with Very Early Administration of Mitoxantrone-A Case Report

Abstract

Marburg variant is a severe and fulminant pseudotumor form of multiple sclerosis (MS) with high morbidity and mortality rates. Because of its scarcity, it remains incompletely characterized and physicians' experiences will influence the treatment. We report the inflammatory explosive case of a 31-year-old woman presenting with rapid neurological degradation of histology proven Marburg's disease, successfully treated with early administration of Mitoxantrone (MITX). To our knowledge, it is the first case describing complete remission after MITX in a biopsy-proven condition.

Keywords: Case report; Marburg’s variant; Mitoxantrone; Multiple sclerosis.

Fig. 1

Magnetic resonance imaging and biopsy neuropathological findings. a MRI follow-up in sagittal fluid-attenuated inversion recovery (FLAIR) and axial diffusion images tracked over time revel a large hyperintense right frontal lesion with imprecise boundaries extended to the white matter. b Lymphoid nodule in brain section (hematoxylin–eosin–saffron HES ×200). c Lymphoid nodules are mostly composed of T lymphocytes (anti-CD3 immunostaining ×200). d Luxol Fast Blue staining ×40 reveals myelin loss in some areas (arrow). e AntiCD20 immunostaining ×200 revealed some B lymphocytes in lymphoid nodules. f Anti-CD68 immunostaining ×200 showed numerous positive macrophages. g Anti-neurofilament immunostaining (×40) showed that axons are preserved in demyelinated areas (arrow)