Table 1

Laboratory data

Routine	Full blood count and metabolic panel: normal Serum vitamin B₁₂: 237 pg/dL; folic acid: 8.3 ng/dL
Cerebrospinal fluid	Glucose, 0.53 g/L; protein, 0.41 g/L; white blood cell count, 38×10⁶/L (77% lymphocytes, 16% monocytes, 5% plasmocytes, 1% neutrophils) Oligoclonal bands: positive; elevated gamma-globulin levels Cytology: negative
Hormone panel
Diminished	Thyroid-stimulating hormone: 1.90 μIU/mL; free thyroxine: 0.83 ng/dL; growth hormone: 0.07ng/mL; IGF-1: 114 ng/mL; IGFBP3: 4.1 mg/mL; follicle-stimulating hormone: 0.9 IU/L; luteinising hormone: 0.5 IU/L; cortisol <1 µg/mL
Elevated	Prolactin: 28.3 ng/mL
Negative	Beta human chorionic gonadotropin
Oncological markers
Negative	Serum: carcinoembryonic antigen, alpha-fetoprotein, CA 72.4, CA 19.9, CA 15.3, CA 125, prostate-specific antigen, β₂ microglobulin
Negative	Cerebrospinal fluid: alpha-fetoprotein, beta human chorionic gonadotropin, immunophenotyping for oncological cells
Inflammatory and autoimmune	Erythrocyte sedimentation rate: 14 mm; serum C-reactive protein: 5.3 mg/dL; C3, C4: normal; ferritin: 83.9 ng/mL
Negative	Rheumatoid factor, antinuclear antibody, double-stranded DNA, cytoplasmic ANCA; anti-thyroid peroxidase, anti-thyroglobulin, anti-parietal cell and anti-smooth muscle antibodies
Infectious
Negative	Blood: HIV 1/2, HTLV 1/2, VDRL, hepatitis C virus, hepatitis B virus, anti-cytomegalovirus IgM, anti-VCA IgM, anti-toxoplasma IgM, anti-rubella IgM
Negative	Cerebrospinal fluid: culture, acid-fast bacilli, cryptococcus antigen, VDRL, Mycobacterium tuberculosis PCR, cytomegalovirus PCR, HSV I/II PCR, HTLV 1/2, adenovirus PCR, Varicella zoster virus, B19 parvovirus

ANCA, anti-neutrophilic cytoplasmic antibody; HSV, herpes simplex virus; HTLV, human T-cell lymphotropic virus; IGF-1, insulin-like growth factor 1; IGFBP3, insulin-like growth factor binding protein 3; VDRL, venereal disease research laboratory test; VCA, Epstein–Barr virus viral-capsid antigen.