Glucocorticosteroid treatment for cerebrospinal fluid eosinophilia in a patient with ventriculoperitonial shunt

Background: Cerebrospinal fluid (CSF) eosinophilia commonly occurs in patie nts with ventriculoperitoneal (VP) shunts and is associated with shunt comp lications such as obstruction or infection. Glucocorticosteroids (GCS) are effective in reducing eosinophilia and eosinophils in skin, nasal mucosa, a nd airway epithelium. Effects of GCS on CSF eosinophils has not been report ed. Objective: To demonstrate glucocorticosteroid effects on the CSF eosinophil levels and to propose that GCS may be used as a therapeutic agent for CSF eosinophilia. Result: A case report of a patient with congenital hydrocephalus and a VP s hunt developed CSF eosinophilia associated with latex allergy and shunt mal function. Daily treatment with 2 mg/kg of methylprednisolone was associated with reduced peripheral eosinophilia and slightly reduced CSF eosinophil c ounts. Pulse methylprednisolone, 25 mg/kg, was associated with complete red uction of CSF eosinophils and prolonged VP shunt survival. Conclusion: Systemic glucocorticosteroids effectively reduce CSF eosinophil s. Glucocorticosteroids may be beneficial for treatment of CSF eosinophilia associated with VP shunt malfunction.