Background

Cerebral proliferative angiopathy is a vascular malformation associated with compromised blood-brain barrier and with migraine-like headache. Treating blood-brain barrier-compromised patients with erenumab, an anti-calcitonin gene-related peptide receptor monoclonal antibody, may be risky.

Case

We describe a case of a 22-year-old chronic migraine patient with cerebral proliferative angiopathy who presented to our hospital in status epilepticus 2 d after his first dose of erenumab. Serial magnetic resonance imaging (MRI) studies demonstrated progressive areas of diffusion restriction including the brain tissue adjacent to the cerebral proliferative angiopathy, bilateral white matter and hippocampi. His 6-month post-presentation magnetic resonance imaging was notable for white matter injury, encephalomalacia surrounding cerebral proliferative angiopathy and bilateral hippocampal sclerosis. He remains clinically affected with residual symptoms, including refractory epilepsy and cognitive deficits.

Conclusion

The evidence presented in this case supports further investigation into potential deleterious side effects of erenumab in patients with compromised blood-brain barrier, such as individuals with intracranial vascular malformations.

中文翻译：

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erenumab 对脑增殖性血管病的不良反应：病例报告。

背景

脑增殖性血管病是一种血管畸形，与血脑屏障受损和偏头痛样头痛有关。用erenumab（一种抗降钙素基因相关肽受体单克隆抗体）治疗血脑屏障受损的患者可能存在风险。

案件

我们描述了一例患有脑增殖性血管病的 22 岁慢性偏头痛患者，他在第一剂 erenumab 后 2 天因癫痫持续状态就诊于我们医院。连续磁共振成像 (MRI) 研究表明扩散受限的进行性区域包括与脑增殖性血管病相邻的脑组织、双侧白质和海马。他在出院后 6 个月的磁共振成像中以白质损伤、脑增殖性血管病周围的脑软化症和双侧海马硬化症着称。他在临床上仍然受到残留症状的影响，包括难治性癫痫和认知缺陷。

结论

本案例中提供的证据支持进一步调查 erenumab 对血脑屏障受损患者（例如颅内血管畸形患者）的潜在有害副作用。