case_images: PMC5588250_01
case_images: a The first MRI before the therapy. b A new lesion in the follow-up MRI after methylprednisolone therapy (arrow). c Follow-up MRI after 5 cycles of plasmapheresis.
case_images: mpp-0024-0388-g01.jpg
case_images: PMC5588250_01_mpp-0024-0388-g01.jpg
case_images: F1
case_images: A 1.5-T magnetic resonance imaging (MRI) of the brain revealed multiple periventricular hyperintensities in FLAIR, with hypointensities in T1, a sever lesion load in T2/FLAIR images, black holes in T1 and multiple fresh inflammatory foci after gadolinium enhancement (fig. 1a). The symptoms improved after the treatment course, but new lesions were detected in the follow-up MRI (fig. 1b). Consequently, plasmapheresis was started which led to the subsiding of both the symptoms and the MRI lesions after 5 well-tolerated apheresis cycles with a median exchange volume of 3 liters (range 2.5-3.5) (fig. 1c).