{
  "abstract": "Central nervous system graft-versus-host disease (CNS GVHD) is a rare and challenging complication of allogeneic hematopoietic stem cell transplantation (HSCT) that can mimic infection, malignancy, or primary demyelinating disorders. We describe a 21-year-old man with high-risk Philadelphia chromosome–like B-cell acute lymphoblastic leukemia underwent matched unrelated donor allogeneic HSCT after achieving measurable residual disease negativity. His post-transplant course was complicated by hepatic and cutaneous GVHD. Sixteen months after transplantation, he developed progressive bilateral lower-extremity weakness, gait ataxia, and blurred vision. Brain MRI demonstrated multifocal subcortical lesions, while spinal MRI revealed enhancing intramedullary lesions at multiple levels. Orbital MRI showed bilateral optic neuritis. Extensive infectious, malignant, and autoimmune evaluations were unrevealing. Given his prior GVHD, multifocal demyelinating pattern, exclusion of alternative etiologies, and response to immunosuppression, probable demyelinating CNS GVHD was diagnosed. He was treated with corticosteroids, IVIG, plasma exchange, and rituximab, followed by maintenance IVIG and prednisone, with substantial clinical and radiographic improvement. CNS GVHD should be considered in HSCT recipients with new multifocal neurologic deficits and demyelinating lesions, particularly with antecedent systemic GVHD. Early recognition and immunosuppressive treatment may improve neurologic outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiology Florida International University/Herbert Wertheim College of Medicine",
    "Department of Radiology Baptist Health South Florida (Miami, Florida, USA) / Radiology Associates of South Florida (RASF)/Division of Clinical Neuroradiology",
    "Department of Radiology Diagnósticos da América S.A., DASA, São Paulo, Brazil",
    "Department of Radiology Universidade de Ribeirão Preto Campus Guarujá, Guarujá (SP)",
    "Instituto de Ensino e Pesquisa DASA, IEPD, São Paulo, Brazil",
    "Department of Radiology Florida International University (FIU)/Herbert Wertheim College of Medicine"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Marie Ugo"
    },
    {
      "affs": [
        0
      ],
      "name": "Aaliyah Shaikh"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Charif Sidani"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Márcio L Duarte"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Leonardo F Freitas"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c1zw2mzw9vgc5.bib",
  "cited_by": 0,
  "doi": "10.56305/001c.168646",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13730617/?tool=EBI",
  "id": "c1zw2mzw9vgc5",
  "issns": [
    "2994-5593"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13730617",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Images in Hospital Medicine"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7225100930",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13730617/pdf/?tool=EBI",
  "pmcid": "PMC13730617",
  "pmid": "42979616",
  "published": "2026-10-02",
  "publisher": "Department of Medicine of Alpert Medical School of Brown University",
  "ris": "https://research.draconitic.com/paper/c1zw2mzw9vgc5.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13730617",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13730617"
    },
    {
      "first_seen": "2026-11-07T12:23:08Z",
      "native_id": "PMC13730617",
      "source": "pmc",
      "url": "https://doi.org/10.56305/001c.168646"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Hematopoietic Stem Cell Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Immune-Mediated Demyelinating Central Nervous System Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation",
  "title_text": "Immune-Mediated Demyelinating Central Nervous System Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:08Z",
  "url": "https://research.draconitic.com/paper/c1zw2mzw9vgc5",
  "venue": "Journal of Brown hospital medicine",
  "versions": []
}