• Medicine · Nov 2022

    Case Reports

    Anemia - an initial manifestation of Bing-Neel syndrome: A case report.

    • Xiaoqian Yang, Zonglei Chong, Congcong Ma, Guifang Wang, and Chunxia Yan.
    • Department of Neurology, Liaocheng People's Hospital, Shandong, China.
    • Medicine (Baltimore). 2022 Nov 18; 101 (46): e31239e31239.

    RationaleIt is very likely that we will miss Bing-Neel syndrome (BNS) when its initial sign is anemia.Patient concerns: A 59-year-old woman presented with episodic loss of consciousness, anemia, and extremity muscle strength scores (5-) and extremity tendon reflexes (++).DiagnosesMagnetic Resonance Imaging (MRI) showed abnormal signal in the left hippocampus, left insula, and right occipital lobe. Quantitative serum immunoglobulins showed elevated immunoglobulinm (IgM) (60.6g/L). Bone marrow biopsy showed lymphoplasmacytic lymphoma (LPL) and tested positive for the MYD88 L265P mutation suggesting Waldenström macroglobulinemia (WM).InterventionsThe patient underwent 3 plasma exchange treatments in the department of hematology followed by chemotherapy (cyclophosphamide for injection, bortezomib for injection).OutcomesThe patient's condition improved after treatment.LessonsClinicians must remain vigilant, as BNS may be the only sign of WM progression in a patient well-controlled on treatment.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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