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Neurological rarities
Acute posterior multifocal placoid pigment epitheliopathy resembling multiple sclerosis
  1. Sahla El Mahdaoui1,
  2. Asher Lou Isenberg1,
  3. Klaus Hansen2,
  4. Annika Reynberg Langkilde3,
  5. Steffen Hamann4,
  6. Jeppe Romme Christensen1
  1. 1 Danish Multiple Sclerosis Center, Copenhagen University Hospital Department of Neurology, Glostrup, Denmark
  2. 2 Copenhagen University Hospital Department of Neurology, Copenhagen, Denmark
  3. 3 Copenhagen University Hospital Department of Radiology, Copenhagen, Denmark
  4. 4 Copenhagen University Hospital Department of Ophthalmology, Glostrup, Denmark
  1. Correspondence to Sahla El Mahdaoui, Danish Multiple Sclerosis Center, Copenhagen University Hospital Department of Neurology, Glostrup 2600, Denmark; sahla.el.mahdaoui.01{at}regionh.dk

Abstract

A 23-year-old man presented with right eye blurred vision; he was diagnosed with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and his symptoms resolved with prednisolone. Two months later, he developed a right arm weakness that resolved after 3 weeks. MR scan of brain identified changes suggesting multiple sclerosis, with four hyperintense FLAIR lesions; there was contrast enhancement of two lesions and no diffusion restriction. Cerebrospinal fluid showed mononuclear pleocytosis. We eventually diagnosed these as APMPPE-associated CNS lesions. APMPPE is a rare inflammatory chorioretinopathy that rarely can resemble multiple sclerosis clinically and radiologically.

  • multiple sclerosis
  • vasculitis
  • stroke
  • MRI
  • ophthalmology

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

https://doi.org/10.1136/pn-2022-003463

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    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

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    Footnotes

    • Contributors SEM, AI and JRC contributed to conception and/or design. SEM and AI drafted the manuscript, and KH, AL, SH and JRC revised it critically. All authors contributed substantially to the acquisition and interpretation of data and approved of the final version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests SEM, AI, KH, AL and SH report no conflicts of interest. JRC reports receiving speaker honoraria from Biogen and being a member of the steering committee of the DanNORMS study (NCT04688788) and receiving grants from the Medicine Fund of the Danish Regions.

    • Provenance and peer review Not commissioned; externally peer reviewed by Neil Scolding, Bristol, UK and Christian Lueck, Canberra, Australia.