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Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab.

Authors :
Gibson AW
Elser H
Rosso M
Cornblath EJ
Fonkeu Y
Prasad S
Rothstein A
Nasrallah IM
Wolk DA
Guo MH
Source :
Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2024 Nov; Vol. 20 (11), pp. 8192-8197. Date of Electronic Publication: 2024 Aug 30.
Publication Year :
2024

Abstract

Introduction: Anti-amyloid antibody therapies such as lecanemab are increasingly being used to treat Alzheimer's disease (AD). These therapies are associated with a high rate of amyloid-related imaging abnormalities (ARIA).<br />Methods: We review the case history of a patient who developed ARIA associated with lecanemab treatment.<br />Results: In addition to microhemorrhages and cerebral edema that are recognized features of ARIA, the patient developed several ischemic strokes. The patient also experienced frequent electrographic seizures without overt clinical seizures. The patient demonstrated clinical and radiographic improvement after steroid treatment.<br />Discussion: Our case suggests that ischemic strokes may be a feature of ARIA and highlights the importance of having a high clinical suspicion for seizures in ARIA. As anti-amyloid therapies are likely going to be increasingly used to treat AD, it is important to appreciate the spectrum of clinical and radiographic findings that can result as side effects from this class of therapies.<br />Highlights: We report a patient who developed severe amyloid-related imaging abnormalities (ARIA) after treatment with lecanemab. Our report suggests that ischemic strokes may be a novel imaging feature of ARIA. Our report highlights the need for high clinical suspicion for seizures in ARIA.<br /> (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Details

Language :
English
ISSN :
1552-5279
Volume :
20
Issue :
11
Database :
MEDLINE
Journal :
Alzheimer's & dementia : the journal of the Alzheimer's Association
Publication Type :
Academic Journal
Accession number :
39215494
Full Text :
https://doi.org/10.1002/alz.14223