Immune profiling unveils the systemic cytokine milieu associated with acute reversible encephalopathy with cytotoxic lesions of the corpus callosum (CLOCCs)

Encephalopathy with cytotoxic lesions of the corpus callosum (CLOCCs) represents a clinical-radiological entity characterized by MRI evidence of lesions involving the splenium of the corpus callosum and a collection of neurological symptoms ranging from consciousness impairment to seizures and focal neurological signs. The most widely accepted pathophysiological mechanism underlying CLOCCs is thought to be represented by a phenomenon of cytokine-induced cytotoxic edema but its exact immune pathogenesis is still unravelled and targeted treatments are lacking. Here, we report the case of a 18-year-old male with CLOCCs associated with acute Epstein-Barr virus (EBV) infection, in whom the systemic immune response across acute and post-acute phases was characterized for the first time through longitudinal cytokine profiling. The obtained data pave the way to a more precise comprehension of CLOCCs pathogenesis and an individualized treatment of this potentially severe condition.