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Терапевтические проблемы у пациентов с множественным склерозом и анкилосирующим спондилитом: серия случаев.

Множественный склероз (MS) — хроническая иммунная болезнь, затрагивающая более 2 миллионов человек во всем мире. Сообщалось о сосуществовании с другими аутоиммунными расстройствами, такими, как системная волчанка (SLE). Однако сообщения о том, что пациенты, страдающие склерозом, одновременно диагностировали анкилозирующий спондилит (АС), редки, вероятно, из-за различий в иммуногенных путях. Регулирование пациентов, имеющих как MS, так и AS, сопряжено с клинической проблемой, особенно из-за кондиционирования ингибиторов TNF-α (TNFi) в MS. Мы представляем трёх пациентов с соотечественниками MS и

Совпадение в аннотации оригинала
BACKGROUND: Multiple Sclerosis (MS) is a chronic immune-mediated disease affecting >2 million people worldwide. Coexistence with other autoi … st common MS subtype, and typical presentations included sensory deficits, spastic paraparesis, and optic neuritis. CSF oligoclonal bands were positive in 11 of the 13 cases where lumbar puncture results were reported. TNFi were used in eight patients for AS and were discontinued in all eight due to concern for demyelination. Diagnosis of MS in these patients ha …

Effects of disease-modifying therapies on remyelination in multiple sclerosis; evaluation via visual evoked potential test.

BACKGROUND: Assessment of the visual pathway, which is frequently affected by MS, provides the opportunity to measure the remyelination of acute and chronic MS lesions in vivo and non-invasively. VEP can be used in this context. Amplitude is a parameter of axonal loss, whereas latency is an in vivo biomarker of myelin repair. This study aimed to evaluate DMT's neuroprotective and pro-remyelinating potential by evaluating VEP latency and amplitude in MS patients. MATERIALS AND METHODS: A total of 74 patients with relapsing MS who had no evidence of optic neuritis were included in the study. Pa…

Frequency of anti-MOG antibodies in serum and CSF of patients with possible autoimmune encephalitis: Results from a Brazilian multicentric study.

INTRODUCTION: MOGAD encephalitis and ADEM share several clinical features with autoimmune encephalitis (AE) associated with antineuronal ant … disorders (MOGAD 42 % x AE 81 %, p = 0.0017) and more demyelinating symptoms, such as myelitis and optic neuritis (MOGAD 14 % x AE 0 %, p = 0.013). CONCLUSION: Approximately 3.5 % of patients with possible AE harbor anti-MOG abs, and 0.9 % of the adults had MOGAD encephalitis. Anti-MOG abs were more frequent than other ANeAs regularly tested in AE. We provide …

Progressive Neurosarcoidosis Presenting as Idiopathic Hypopituitarism With Atypical Radiological Features for 13 Years.

Sarcoidosis is an immune-mediated multisystem condition of unknown etiology, characterized by non-caseating granulomatous inflammation. Whil … After 13 years, he developed further symptoms of neurosarcoidosis including cerebellar infarction, optic neuritis, and paralysis in lower limbs and later developed systemic sarcoidosis including erythema nodosum and cervical lymphadenopathy. Initially, his MRI of the brain showed a decrease in the size of the pituitary gland in 2004, and there were no other fea …

Measuring and predicting the effect of remyelinating therapy in multiple sclerosis: a randomised controlled trial protocol (RESTORE).

INTRODUCTION: Remyelination failure hampers symptomatic recovery in multiple sclerosis (MS), underlining the importance of developing remyelinating therapies. Optic neuritis is currently the most established method of measuring remyelination in MS trials. Complementary more generalisable methods of measuring remyelination are required to confirm treatment efficacy. Measuring internuclear ophthalmoplegia (INO) with infrared oculography provides such a method. Moreover, this method can be expanded with a test for selecting likely treatment responders by using fampridine. The aim of this trial is…

Myelin Oligodendrocyte Glycoprotein Antibodies in Adults with a First Demyelinating Event Suggestive of Multiple Sclerosis.

OBJECTIVE: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most c … OG-Ab were positive in 17 of 630 (2.7%). Fourteen out of 17 (82.4%) MOG-Ab+ patients presented with optic neuritis (ON) compared to 227of 613 (37.0%) MOG-Ab- patients (p = 0.009). Cerebrospinal fluid-restricted oligoclonal bands (CSF-OBs) were found in 2 of 16 (12.5%) MOG-Ab+ versus 371 of 601 (61.7%) MOG-Ab- subjects (p < 0.001). Baseline brain magnetic resonan …

Clinical characteristics of patient with GFAP-IgG: a review of 31 patients from two tertiary referral centers in China.

OBJECTIVE: This study presents a comprehensive analysis of the clinical characteristics of 31 patients exhibiting cerebrospinal fluid (CSF) … tcomes, involving the brain, meninges, and spinal cord. Besides, seven of the 24 patients developed optic neuritis. The CSF protein levels positively correlated with the Expanded Disability Status Scale score (EDSSs). Significantly decreased EDSSs, modified Rankin Scale score, GFAP-IgG titer, CSF protein level, and CSF white blood cell counts were observed after …

A comparison of the efficacy of tocilizumab versus azathioprine for neuromyelitis optica spectrum disorder: A study protocol for systematic review and meta-analysis.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a chronic inflammatory disease of the nervous system, which is frequently accompanied by a pathological humoral immune response against aquaporin-4 water channel. The most common feature of the disorder is recurrent episodes of longitudinally extensive transverse myelitis and optic neuritis. Frequent relapse leads to the gradual accumulation of neurological dysfunction. Azathioprine (AZA) is an empirical attack -preventive immunotherapies drug to prevent the relapse of NMOSD, and tocilizumab (TCZ) has been also reported reduce the a…

Is there a correlation between MOG-associated disorder and SARS-CoV-2 infection?

BACKGROUND AND PURPOSE: Anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) distinguish a group of inflammatory disorders which ca … 85-9.17). The most common clinical presentations of MOGAD SARS-CoV-2-seropositive patients included optic neuritis (n = 6) and myelitis (n = 3). The number of diagnosed cases increased over the last 3 years, in particular, when including cases referred to us before the COVID-19 pandemic, in the initial phase of the first wave and in the late phase of the second …

Acute symptomatic seizures secondary to myelin oligodendrocyte glycoprotein antibody-associated disease.

OBJECTIVE: To report the clinical presentations and outcomes of patients with seizure and myelin oligodendrocyte glycoprotein antibody-assoc … h seizure recurrence is uncommon, many patients have MOGAD relapses in the form of encephalitis and optic neuritis.

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) in Chile: lessons learned from challenging cases.

BACKGROUND: Anti-Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease (MOGAD) is an emerging disorder recognized as a clini … on 24 months (range 12-348). In the whole cohort, the most frequent symptoms at onset were isolated optic neuritis (ON) (34%) and myelitis (22%). Encephalitis with seizures or encephalomyelitis was the most common presentation in paediatric-onset patients 75% (n = 6), compared to 11% (n = 3) of the adult-onset patients (p < 0.001). A relapsing course was observe …

The incidence, risk factor, and time to develop rheumatologic diseases after isolated inflammatory eye diseases: a 12-year cohort study.

OBJECTIVE: The incidence, risk factors, and time to diagnosis of rheumatologic disease (RD) in patients with isolated inflammatory eye disea … nted with IED including scleritis, anterior uveitis (AU), retinal vasculitis (RV), keratopathy, and optic neuritis (OP). AU, RV, keratopathy, and OP were associated with RD development. The incidence of RD was 36% during 12 years. RD developed most frequently in AU (55.5%) and RV (22.2%). The longest duration for RD development was 5.5 years. Prevalence of posit …

An evaluation of postmarketing reports of hyperglycaemia associated with dolutegravir for treatment of HIV in Eswatini.

BACKGROUND: Dolutegravir (DTG) is an Integrase Strand Transfer Inhibitor (INSTI) indicated in combination with other antiretroviral agents f … in the study. Seven of the reports were serious (resulted in hospitalization and one case concerned optic neuritis, leading to blindness). Two patients had a medical history of diabetes while the rest of the patients had never experienced hyperglycaemia before starting dolutegravir. For all the reports, the time to onset of hyperglycaemia ranges from 2-5 months …

B Cells in the CNS at Postmortem Are Associated With Worse Outcome and Cell Types in Multiple Sclerosis.

BACKGROUND AND OBJECTIVES: To define the clinical and pathologic correlations of compartmentalized perivascular B cells in postmortem progre … r, spinal cord, and pyramidal onset (Coeff = 0.274; 95% CI = 0.039, 0.510; p = 0.022) compared with optic neuritis and sensory onset. Higher CD20 immunostaining intensity was associated with younger age at onset (hazard ratio [HR] = 1.033; 95% CI = 1.013, 1.053; p = 0.001), SP conversion (HR = 1.056; 95% CI = 1.022, 1.091; p = 0.001), wheelchair dependence (HR = …

Treatment and outcome of aquaporin-4 antibody-positive NMOSD: A multinational pediatric study.

OBJECTIVE: To describe the clinical phenotypes, treatment response, and outcome of children with antibodies against aquaporin-4 (AQP4-Ab) ne … on rituximab (n = 29, range 0-2). No patient treated with rituximab as first-line therapy relapsed. Optic neuritis at onset was associated with a poor visual outcome below 20/200 (OR 8.669, 95% CI 1.764-42.616, p = 0.008), and a younger age at onset was associated with cognitive impairment (OR 0.786, 95% CI 0.644-0.959, p = 0.018). CONCLUSIONS: AQP4-Ab NMOSD in …

Gypenosides attenuate retinal degeneration in a zebrafish retinitis pigmentosa model.

Retinitis pigmentosa (RP) is a collection of heterogenous genetic retinal disorders resulting in cumulative retinal deterioration involving progressive loss of photoreceptors and eventually in total blindness. Oxidative stress plays a central role in this photoreceptor loss. Gypenosides (Gyp) are the main functional component isolated from the climbing vine Gynostemma pentaphyllum and have been shown to defend cells against the effects of oxidative stress and inflammation, providing protection in experimentally-induced optic neuritis. The zebrafish model has been used to investigate a range of…

Clinical and immunological differences between MOG associated disease and anti AQP4 antibody-positive neuromyelitis optica spectrum disorders: Blood-brain barrier breakdown and peripheral plasmablasts.

BACKGROUND: Patients with anti-aquaporin-4 (AQP4) water channel antibody-positive neuromyelitis optica spectrum disorders (AQP4-NMOSD) and m … and chronic phases. RESULTS: In the comparative study on clinical symptoms, a large proportion of optic neuritis was unilateral in MOGAD. In the comparative study on CSF analysis, protein level was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.006); myelin basic protein was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.04); albumi …

Epidemiological findings of neuromyelitis optica spectrum disorders in a Venezuelan study.

BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD), is a rare autoimmune inflammatory disease of the central nervous system. Since … stizos constituted 86,7% of this cohort. Most of the patients presented initially with simultaneous optic neuritis (ON) and acute transverse myelitis (ATM) and a recurrent course was registered in 82.3% of cases. The mean of the expanded disability status scale (EDSS) was 3.5 (IQR 2-7). Abnormal brain and spine MRI were present in 47.8% and 81.1% of patients, re …

Spectrum of Orbital Cellulitis on Magnetic Resonance Imaging.

Introduction Orbital infection is an ophthalmological emergency as it can lead to blindness and intracranial spread. Imaging is needed to de … as found to be the most common complication of orbital cellulitis (eight cases, 53.3%), followed by optic neuritis/perineuritis (four cases, 26.67%), intracranial involvement (four cases, 26.67%), dacryoadenitis (three cases, 20%) and cavernous sinus thrombophlebitis (three cases, 20%). Seven cases (46.67%) had right orbital involvement. Sinusitis was found to b …

Tryptophan immunoadsorption during pregnancy and breastfeeding in patients with acute relapse of multiple sclerosis and neuromyelitis optica.

BACKGROUND: Up to every fourth woman with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) suffers a clinically rel … using Expanded Disability Status Scale (EDSS) and visual acuity (VA) measurements for patients with optic neuritis (ON). RESULTS: A total of 24 patients were analyzed, 23 with relapsing-remitting MS, and 1 with NMOSD. Twenty patients were treated with IA during pregnancy. Four patients received IA postnatally during the breastfeeding period. Treatment was start …