Another paper from Dr Taieb appeared recently, again pondering on the relationship of CLIPPERS to other central nervous system disorders. In this short letter, "A central nervous system B-cell lymphoma arising two years after initial diagnosis of CLIPPERS", he considers a new case where an initial diagnosis of CLIPPERS was made which was based on tests including brain biopsy. Eighteen months later the patient relapsed whilst still taking Prednisolone and a diagnosis of presumed central nervous system B-cell lymphoma was made.
These cases are always worrying for those of us being treated for CLIPPERS. I guess the diagnosis had to change as the patient was no longer "responsive to steroids" which is required for CLIPPERS. But as ever, the question is, was this a simple case of mis-diagnosis under difficult conditions (not least as Lymphoma can also respond to steroids initially) or was it suggestive of CLIPPERS progressing to something else? Dr Taieb considers both these scenarios as possible and doesn't offer an opinion about which scenario he thinks most likely. It is also worth mentioning that Dr Taieb says that this case is one patient out of twelve studied in the 2012 French CLIPPERS cohort, the rest of whom (presumably) retained their original CLIPPERS diagnosis.
In other news, my shingles rash didn't get any worse and has largely cleared up. I have no idea if seven days of Acyclovir five times a day helped or not, but the rash stayed fairly localised. From what I have read, this was pretty mild for shingles as any discomfort stayed at the level of an annoying ache.
Read other articles in this series at Living With CLIPPERS.
Living With CLIPPERS by Bill Crum is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
