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August 8, 1980

CSF Eosinophilia Following Myelography

JAMA. 1980;244(6):548. doi:10.1001/jama.1980.03310060012009

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To the Editor.—  The article "CSF Eosinophilia Following Myelography" (242:2432, 1979) by Holley and Al-Ibrahim calls to mind a remarkably similar case that I saw in 1965.

Report of a Case.—  A 46-year-old woman had negative results on a myelogram, confirming a diagnosis of the Roussy-Levy syndrome. Ten days after a myelographic examination, she experienced the onset of progressively increasing pain in the back and legs, that was worse when supine, making it impossible for her to lie down at all. She had no signs of meningeal irritation but was considered to have a pantopaque arachnoiditis. The CSF contained 1,280 WBCs per cubic millimeter, of which 32% were initially described as polymorphonuclear leukocytes and 68% as mononuclear cells. However, a Wright's stain performed on the CSF showed that 90% of what were thought to be polymorphonuclear leukocytes were actually eosinophils (Table). Therapy with prednisone, 60 mg daily, was started, and