Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

Rojelio Mejia Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas; Gastrointestinal Parasites Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland

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Theodore E. Nash Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas; Gastrointestinal Parasites Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland

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Calcified Taenia solium granulomas are the focus of repeated episodes of perilesional edema and seizures in 50% of persons with calcifications, history of seizures, and a positive serology for cysticercosis. The pathophysiology is unclear but recent studies suggest the edema is caused by inflammation. We report two new cases and four other published cases where cessation of corticosteroids appeared to result in recurrence or new appearance of perilesional edema around calcifications. This suggests that perilesional edema is an immune-mediated phenomenon.

Author Notes

* Address correspondence to Theodore E. Nash, Bldg. 4, Gastrointestinal Parasites Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892. E-mail: tnash@niaid.nih.gov

Financial support: This study was supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases; U.S. National Institutes of Health.

Authors' addresses: Rojelio Mejia, Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, and National Institute of Allergy and Infectious Diseases, Laboratory of Parasitic Diseases, Bethesda, MD, E-mail: rojelio.mejia@bcm.edu. Theodore E. Nash, National Institute of Allergy and Infectious Diseases, Laboratory of Parasitic Diseases, Bethesda, MD, E-mail: tnash@niaid.nih.gov.

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