Bing-Neel syndrome successfully treated with venetoclax and zanubrutinib: A case report and review of the literature.
Shenhe Jin, Yuhui Wu, Jin Zhang
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Case in brief
A 66-year-old woman with Waldenström macroglobulinemia presented with headache and was diagnosed with Bing-Neel syndrome after cerebrospinal fluid examination. She received zanubrutinib with venetoclax. Her symptoms resolved, and follow-up cerebrospinal fluid no longer showed abnormal B lymphocytes. Venetoclax was detected in cerebrospinal fluid.
What made this case unusual
Venetoclax was detected in cerebrospinal fluid in this case, alongside clinical and cerebrospinal fluid remission after treatment with venetoclax and zanubrutinib.
Diagnostic / clinical pearl
In a patient with Waldenström macroglobulinemia and neurological symptoms, Bing-Neel syndrome can be diagnosed through cerebrospinal fluid examination; the report highlights the diagnostic role of CSF assessment.
Why it matters
The case adds a report of remission with venetoclax plus zanubrutinib and documented venetoclax in CSF, in a condition for which the abstract notes there is no consensus standard management.