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Review

CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review)

  • Authors:
    • Any Docu Axelerad
    • Alina Zorina Stroe
    • Cristina Mihai
    • Corina Frecus
    • Dragos Catalin Jianu
    • Daniel Docu Axelerad
    • Anca Elena Gogu
  • View Affiliations / Copyright

    Affiliations: Department of Neurology, Faculty of General Medicine, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania, Department of Pediatrics, Faculty of General Medicine, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania, Department of Neurology, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Kinetotherapy, ‘Brainaxy Clinic’, 900628 Constanta, Romania
  • Article Number: 1191
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    Published online on: August 17, 2021
       https://doi.org/10.3892/etm.2021.10625
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Abstract

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a relatively newly discovered and characterized condition affecting the central nervous system (CNS) that involves the brainstem almost ubiquitously and that focuses primarily on the pons. Characteristically, CLIPPERS represents a combination of clinical symptoms related to the pathology of the brainstem in particular and has a characteristic appearance on magnetic resonance imaging (MRI), with punctate and curvilinear gadolinium enhancement ‘peppering’ the pons. The lesions can be viewed via neuroimaging with a predominance in the pons and adjacent rhombencephalic structures, such as the cerebellar peduncles, cerebellum, medulla, and middle brain. These lesions may also spread and appear in other areas of the brain such as the thalamus or white matter. As the name suggests, this clinical syndrome responds to immunosuppressive treatment based on glucocorticosteroids (GCSs), expressed as both clinical and radiological improvements. Support for this treatment is required for a long period, since exacerbations may occur without. Thus, the diagnosis of CLIPPERS has garnered increased attention from clinicians and the active exclusion of differential alternative diagnoses is needed. A specific biomarker of serum or cerebrospinal fluid (CSF) for this condition has not been discovered. The pathophysiology of this condition is not fully elucidated, and it is not yet clear whether CLIPPERS is a disease in its own right or is the culmination of several already known syndromes. Clinicians and radiologists should pay close attention to this condition as it is relatively easy to treat and patients can benefit from the early introduction of GCSs, which can produce significant results through long-term immunosuppression. Taking into account previous reports in the literature, which currently include over 50 cases reported as CLIPPERS, this analysis addressed the clinical features, and paraclinical and differential diagnoses of cases described in the literature.
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1 

Pittock SJ, Debruyne J, Krecke KN, Giannini C, van den Ameele J, De Herdt V, McKeon A, Fealey RD, Weinshenker BG, Aksamit AJ, et al: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). Brain. 133:2626–2634. 2010.PubMed/NCBI View Article : Google Scholar

2 

Kira J: The expanding phenotype of CLIPPERS: Is it a disease or a syndrome? J Neurol Neurosurg Psychiatry. 83:2–3. 2012.PubMed/NCBI View Article : Google Scholar

3 

Jones JL, Dean AF, Antoun N, Scoffings DJ, Burnet NG and Coles AJ: ‘Radiologically compatible CLIPPERS’ may conceal a number of pathologies. Brain. 134(e187)2011.PubMed/NCBI View Article : Google Scholar

4 

De Graaff HJ, Wattjes MP, Rozemuller-Kwakkel AJ, Petzold A and Killstein J: Fatal B-cell lymphoma following chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. JAMA Neurol. 70:915–918. 2013.PubMed/NCBI View Article : Google Scholar

5 

Espinosa G, Font J, Tàssies D, Vidaller A, Deulofeu R, López-Soto A, Cervera R, Ordinas A, Ingelmo M and Reverter JC: Vascular involvement in Behçet's disease: Relation with thrombophilic factors, coagulation activation, and thrombomodulin. Am J Med. 112:37–43. 2002.PubMed/NCBI View Article : Google Scholar

6 

Saigal G and Quencer R: Acute lacunar infarcts in CLIPPERS: Is the chronic infiltrative lymphocytic perivascular disease process to blame? Neuroradiol J. 26:629–635. 2013.PubMed/NCBI View Article : Google Scholar

7 

Taieb G, Duflos C, Renard D, Audoin B, Kaphan E, Pelletier J, Limousin N, Tranchant C, Kremer S, de Sèze J, et al: Long-term outcomes of CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) in a consecutive series of 12 patients. Arch Neurol. 69:847–855. 2012.PubMed/NCBI View Article : Google Scholar

8 

Trejo-Gabriel-Galán JM, Arenaza-Basterrechea N and Sedano-Tous MJ: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS syndrome). Med Clin (Barc). 144:187–188. 2015.PubMed/NCBI View Article : Google Scholar : (In Spanish).

9 

Altintas A, Alpaslan BG and Uygunoglu U: CLIPPERS syndrome: Case report. J Neuroimmunol. 275(413)2014.

10 

Simon NG, Parratt JD, Barnett MH, Buckland ME, Gupta R, Hayes MW, Masters LT and Reddel SW: Expanding the clinical, radiological and neuropathological phenotype of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). J Neurol Neurosurg Psychiatry. 83:15–22. 2012.PubMed/NCBI View Article : Google Scholar

11 

Biotti D, Deschamps R, Shotar E, Maillart E, Obadia M, Mari I, Savatovsky J and Gout O: CLIPPERS: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Practical Neurol. 11:349–351. 2011.PubMed/NCBI View Article : Google Scholar

12 

Blaabjerg M, Ruprecht K, Sinnecker T, Kondziella D, Niendorf T, Kerrn-Jespersen BM, Lindelof M, Lassmann H, Kristensen BW, Paul F and Illes Z: Widespread inflammation in CLIPPERS syndrome indicated by autopsy and ultra-high-field 7T MRI. Neurol Neuroimmunol Neuroinflamm. 3(226)2016.PubMed/NCBI View Article : Google Scholar

13 

Kerrn-Jespersen BM, Lindelof M, Illes Z, Blaabjerg M, Lund EL, Klausen C, Christiansen I, Sellebjerg F and Kondziella D: CLIPPERS among patients diagnosed with non-specific CNS neuroinflammatory diseases. J Neurol Sci. 343:224–227. 2014.PubMed/NCBI View Article : Google Scholar

14 

Buttmann M, Metz I, Brecht I, Brück W and Warmuth-Metz M: Atypical chronic lymphocytic inflammation with pontocerebellar perivascular enhancement responsive to steroids (CLIPPERS), primary angiitis of the CNS mimicking CLIPPERS or overlap syndrome? A case report. J Neurol Sci. 324:183–186. 2013.PubMed/NCBI View Article : Google Scholar

15 

Cipriani VP, Arndt N, Pytel P, Reder AT and Javed A: Effective treatment of CLIPPERS with long-term use of rituximab. Neurol Neuroimmunol Neuroinflamm. 5(e448)2018.PubMed/NCBI View Article : Google Scholar

16 

Duprez TP and Sindic CJM: Contrast-enhanced magnetic resonance imaging and perfusion-weighted imaging for monitoring features in severe CLIPPERS. Brain. 134(e184)2011.PubMed/NCBI View Article : Google Scholar

17 

Gabilondo I, Saiz A, Graus F and Villoslada P: Response to immunotherapy in CLIPPERS syndrome. J Neurol. 258:2090–2092. 2011.PubMed/NCBI View Article : Google Scholar

18 

Izquierdo AG, Muñoz F, Valenzuela R, Gejman R and Raue M: A chilean case of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (clippers): Case report. J Neurol Sci. 357:76–78. 2015.PubMed/NCBI View Article : Google Scholar

19 

Ha AD, Parratt JD, Babu S, Kim SD, Mahant N, O'Neill J, Halpern JP and Fung VS: Movement disorders associated with CLIPPERS. Mov Disord. 29:148–150. 2014.PubMed/NCBI View Article : Google Scholar

20 

Kastrup O, van de Nes J, Gasser T and Keyvani K: Three cases of CLIPPERS: A serial clinical, laboratory and MRI follow-up study. J Neurol. 258:2140–2146. 2011.PubMed/NCBI View Article : Google Scholar

21 

Kleinschmidt-DeMasters BK and West M: CLIPPERS with chronic small vessel damage: More overlap with small vessel vasculitis? J Neuropathol Exp Neurol. 73:262–267. 2014.PubMed/NCBI View Article : Google Scholar

22 

Lefaucheur R, Bourre B, Ozkul-Wermester O, Maltetel D and Wallon D: Stroke mimicking relapse in a patient with CLIPPERS syndrome. Acta Neurol Belg. 115:735–736. 2015.PubMed/NCBI View Article : Google Scholar

23 

Limousin N, Praline J, Motica O, Cottier JP, Rousselot-Denis C, Mokhtari K, Gonzalez-Aguilar A and De Toffol B: Brain biopsy is required in steroid-resistant patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). J Neurooncol. 107:223–224. 2012.PubMed/NCBI View Article : Google Scholar

24 

Marinho PB, Montanaro VV, Barroso Freitas MC and Alvarenga RM: CLIPPERS syndrome: Case report in a Brazilian patient with a long term disease evolution. Mult Scler Relat Disord. 4:311–314. 2015.PubMed/NCBI View Article : Google Scholar

25 

Mélé N, Guiraud V, Labauge P, Oppenheim C, Mas JL and Taieb G: Effective antituberculous therapy in a patient with CLIPPERS: New insights into CLIPPERS pathogenesis. Neurol Neuroimmunol Neuroinflamm. 1(e6)2014.PubMed/NCBI View Article : Google Scholar

26 

Moreira I, Cruto C, Correia C, Alves JE, Taipa R and Pires MM: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): Postmortem findings. J Neuropathol Exp Neurol. 74:186–190. 2015.PubMed/NCBI View Article : Google Scholar

27 

Nakamura R, Ueno Y, Ando J, Matsuda H, Masuda A, Iiduka K, Shingai N, Takanashi M, Yokoyama K, Komatsu N and Hattori N: Clinical and radiological CLIPPERS features after complete remission of peripheral T-cell lymphoma, not otherwise specified. J Neurol Sci. 364:6–8. 2016.PubMed/NCBI View Article : Google Scholar

28 

Ortega MR, Usmani N, Parra-Herran C, Adams DJ, Steingo B and Rammohan KW: CLIPPERS complicating multiple sclerosis causing concerns of CNS lymphoma. Neurology. 79:715–716. 2012.PubMed/NCBI View Article : Google Scholar

29 

Pesaresi I, Sabato M, Desideri I, Puglioli M, Moretti P and Cosottini M: 3.0T MR investigation of CLIPPERS: Role of susceptibility weighted and perfusion weighted imaging. Magn Reson Imaging. 31:1640–1642. 2013.PubMed/NCBI View Article : Google Scholar

30 

Sempere AP, Mola S, Martin-Medina P, Bernabeu A, Khabbaz E and Lopez-Celada S: Response to immunotherapy in CLIPPERS: Clinical, MRI, and MRS follow-up. J Neuroimaging. 23:254–255. 2013.PubMed/NCBI View Article : Google Scholar

31 

Suer D, Yusifova L, Arsava EM, Ekinci G, Us O and Uluc K: A case report of CLIPPERS (Chronic Lymphocytic Inflammation with Pontocerebellar Perivascular Enhancement Responsive to Steroids) syndrome. Clin Neuroradiol. 25:61–63. 2015.PubMed/NCBI View Article : Google Scholar

32 

Tan BL, Agzarian M and Schultz DW: CLIPPERS: Induction and maintenance of remission using hydroxychloroquine. Neurol Neuroimmunol Neuroinflamm. 2(e56)2015.PubMed/NCBI View Article : Google Scholar

33 

Zhang YX, Hu HT, Ding XY, Chen LH, Du Y, Shen CH, Guo Y and Ding MP: CLIPPERS with diffuse white matter and longitudinally extensive spinal cord involvement. Neurology. 86:103–105. 2016.PubMed/NCBI View Article : Google Scholar

34 

Wijntjes J, Wouda EJ, Siegert CE, Karas GB and Vlaar AM: Need for prolonged immunosupressive therapy in CLIPPERS-a case report. BMC Neurol. 13(49)2013.PubMed/NCBI View Article : Google Scholar

35 

Wetter A, Ku peli G, Meila D, Brassel F and Nacimiento W: CLIPPERS syndrome in a patient with a fluctuating cerebellar syndrome. Neurographics. 3:11–13. 2013.

36 

Weng CF, Chan DC, Chen YF, Liu FC and Liou HH: Chronic hepatitis B infection presenting with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report. J Med Case Rep. 9(266)2015.PubMed/NCBI View Article : Google Scholar

37 

Gogu A: New clinical-imagistic features in cerebral venous and sinus thrombosis. Procedia Soc Behav Sci. 191:1650–1659. 2015.

38 

Gogu AE, Pusztai A, Stroe AZ, Docu Axelerad D and Docu Axelerad A: Back pain in rare diseases: A comparison of neck and back pain between spinal cord ischemia and spinal dural arteriovenous fistula. Brain Sci. 10(618)2020.PubMed/NCBI View Article : Google Scholar

39 

Jianu DC, Jianu SN, Motoc AGM, Poenaru M, Petrica L, Vlad A, Ursoniu S, Gogu AE and Dan F: Diagnosis and management of a young woman with acute isolated lateral sinus thrombosis. Rom J Morphol Embryol. 58:1515–1518. 2017.PubMed/NCBI

40 

Gogu A, Lupu M and Axelerad AD: The relationship between ischemic stroke and atrial fibrillation. Procedia Soc Behav Sci. 197:2004–2010. 2015.

41 

Gogu AE, Jianu DC, Dumitrascu V, Ples H, Stroe AZ, Docu Axelerad D and Docu Axelerad A: MTHFR gene polymorphisms and cardiovascular risk factors, clinical-imagistic features and outcome in cerebral venous sinus thrombosis. Brain Sci. 11(23)2020.PubMed/NCBI View Article : Google Scholar

42 

Gogu AE, Motoc AG, Stroe AZ, Docu Axelerad A, Docu Axelerad D, Petrica L and Jianu DC: Plasminogen activator inhibitor-1 (PAI-1) gene polymorphisms associated with cardiovascular risk factors involved in cerebral venous sinus thrombosis. Metabolites. 11(266)2021.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Axelerad AD, Stroe AZ, Mihai C, Frecus C, Jianu DC, Axelerad DD and Gogu AE: CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review). Exp Ther Med 22: 1191, 2021.
APA
Axelerad, A.D., Stroe, A.Z., Mihai, C., Frecus, C., Jianu, D.C., Axelerad, D.D., & Gogu, A.E. (2021). CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review). Experimental and Therapeutic Medicine, 22, 1191. https://doi.org/10.3892/etm.2021.10625
MLA
Axelerad, A. D., Stroe, A. Z., Mihai, C., Frecus, C., Jianu, D. C., Axelerad, D. D., Gogu, A. E."CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review)". Experimental and Therapeutic Medicine 22.4 (2021): 1191.
Chicago
Axelerad, A. D., Stroe, A. Z., Mihai, C., Frecus, C., Jianu, D. C., Axelerad, D. D., Gogu, A. E."CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review)". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1191. https://doi.org/10.3892/etm.2021.10625
Copy and paste a formatted citation
x
Spandidos Publications style
Axelerad AD, Stroe AZ, Mihai C, Frecus C, Jianu DC, Axelerad DD and Gogu AE: CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review). Exp Ther Med 22: 1191, 2021.
APA
Axelerad, A.D., Stroe, A.Z., Mihai, C., Frecus, C., Jianu, D.C., Axelerad, D.D., & Gogu, A.E. (2021). CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review). Experimental and Therapeutic Medicine, 22, 1191. https://doi.org/10.3892/etm.2021.10625
MLA
Axelerad, A. D., Stroe, A. Z., Mihai, C., Frecus, C., Jianu, D. C., Axelerad, D. D., Gogu, A. E."CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review)". Experimental and Therapeutic Medicine 22.4 (2021): 1191.
Chicago
Axelerad, A. D., Stroe, A. Z., Mihai, C., Frecus, C., Jianu, D. C., Axelerad, D. D., Gogu, A. E."CLIPPERS, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A challenge in neurological practice, clinical landmarks (Review)". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1191. https://doi.org/10.3892/etm.2021.10625
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