{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:22:11Z","timestamp":1761920531807,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,7]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>A 26-year-old patient of limited cutaneous sclerosis presented to us with insidious-onset posterior fossa symptoms of headache, vomiting, vertigo and gait imbalance, progressing over a period of 3\u2009weeks. A diagnosis of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids was made by combining the clinical features with radiological evidence showing punctate infiltration of the pons, brainstem and cerebellum. Relevant differentials in the form of neurosarcoid, infections, central nervous system (CNS) lymphoma and Neuro-Behcet\u2019s disease were ruled out by history and investigations. The patient responded dramatically to steroid therapy, and had no neurological deficits after 18 months of follow-up. This case highlights the rare association of a not-so-common immunological disease with a rare neurological disease.<\/jats:p>","DOI":"10.1136\/bcr-2018-226259","type":"journal-article","created":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T11:34:39Z","timestamp":1546860879000},"page":"e226259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) in limited cutaneous sclerosis: a rare disease combination"],"prefix":"10.1136","volume":"12","author":[{"given":"Sucharita","family":"Anand","sequence":"first","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-1866","authenticated-orcid":false,"given":"Animesh","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surjyaprakash Shivnarayan","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,7]]},"reference":[{"key":"2025082707421787000_12.1.e226259.1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq164"},{"key":"2025082707421787000_12.1.e226259.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-301054"},{"key":"2025082707421787000_12.1.e226259.3","first-page":"45","article-title":"CLIPPERS: is it for real?","volume":"30","author":"Safdieh","year":"2012","journal-title":"Neurology Alert"},{"key":"2025082707421787000_12.1.e226259.4","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1001\/archneurol.2012.122","article-title":"Long-term outcomes of CLIPPERS (Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids) in a consecutive series of 12 patients","volume":"69","author":"Taieb","year":"2012","journal-title":"Arch Neurol"},{"key":"2025082707421787000_12.1.e226259.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6071-4"},{"key":"2025082707421787000_12.1.e226259.6","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.7.1427"},{"key":"2025082707421787000_12.1.e226259.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.01.032"},{"key":"2025082707421787000_12.1.e226259.8","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182648b77"},{"key":"2025082707421787000_12.1.e226259.9","doi-asserted-by":"publisher","DOI":"10.5692\/clinicalneurol.53.1322"},{"key":"2025082707421787000_12.1.e226259.10","first-page":"1","article-title":"Idiopathic central nervous system inflammatory disease in the setting of HLA-B27 uveitis","volume":"16","author":"Crowell","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"key":"2025082707421787000_12.1.e226259.11","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.2169\/internalmedicine.8533-16","article-title":"Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) with limbic encephalitis","volume":"56","author":"Ohta","year":"2017","journal-title":"Intern Med"},{"key":"2025082707421787000_12.1.e226259.12","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005377","article-title":"Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) with intracranial epstein-barr virus infection: a case report","volume":"95","author":"Ma","year":"2016","journal-title":"Medicine"},{"key":"2025082707421787000_12.1.e226259.13","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s12185-015-1850-9","article-title":"Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) after treatment for Hodgkin\u2019s lymphoma","volume":"102","author":"Mashima","year":"2015","journal-title":"Int J Hematol"},{"issue":"1-2","key":"2025082707421787000_12.1.e226259.14","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jns.2014.11.022","article-title":"MRI evolution of CLIPPERS syndrome following herpes zoster infection","volume":"348","author":"Wang","year":"2015","journal-title":"J Neurol Sci"},{"key":"2025082707421787000_12.1.e226259.15","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jns.2016.04.052","article-title":"CLIPPERS features before, during and after lymphoma","volume":"366","author":"Taieb","year":"2016","journal-title":"J Neurol Sci"},{"key":"2025082707421787000_12.1.e226259.16","doi-asserted-by":"publisher","DOI":"10.1097\/NEN.0000000000000050"},{"key":"2025082707421787000_12.1.e226259.17","doi-asserted-by":"crossref","unstructured":"Nathaniel Bendahan, Jean-Martin Boulanger. A case of clippers syndrome with atypical distribution associated with multiple myeloma,neurology. 2016;86 P6.111.","DOI":"10.1212\/WNL.86.16_supplement.P6.111"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:42:23Z","timestamp":1756305743000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,7]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/bcr-2018-226259"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226259","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}