Demyelinating diseases of the central nervous system in children: lecture for practicing pediatricians
- Authors: Kotov A.S.1, Panteleeva M.V.1, Mukhina E.V.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: Vol 49, No 3 (2021)
- Pages: 239-244
- Section: LECTURE
- URL: https://almclinmed.ru/jour/article/view/1513
- DOI: https://doi.org/10.18786/2072-0505-2021-49-034
- ID: 1513
Cite item
Full Text
Abstract
Demyelinating diseases (DD) are autoimmune disorders that morphologically manifest mainly with myelin destruction in the central nervous system (CNS). Recently, there has been a continuous increase in DD of the CNS, including those in the pediatric population. Despite the active development of strategies for the diagnosis of DD and verification of its forms, the differential diagnosis of DD and other diseases associated with abnormalities in the brain white matter structure on magnetic resonance imaging continues to be problematic. We examined 123 patients with suspected DD CNS. The diagnosis was confirmed in 102 of them. The most common form of DD CNS was multiple sclerosis found in 79 of 102 subjects. Much less frequent were anti-MOG-associated disorders (5 patients), neuromyelitis optica spectrum disorders (3 patients), and acute disseminated encephalomyelitis (2 patients). The main clinical, laboratory and neuroimaging characteristics of each of these disorders and the main difficulties in the treatment of pediatric patients with DD CNS are described.
Keywords
About the authors
A. S. Kotov
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: alex-013@yandex.ru
ORCID iD: 0000-0003-2988-5706
Alexey S. Kotov - MD, PhD, Associate Professor, Professor of Chair of Neurology, Postgraduate Training Faculty; Head of Department of Neurology.
61/2-10 Shchepkina ul., Moscow, 129110.
Tel.: +7 (926) 284 81 15.
РоссияM. V. Panteleeva
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Margarita V. Panteleeva - MD, PhD, Senior Research Fellow, Department of Neurology.
61/2 Shchepkina ul., Moscow, 129110.
РоссияE. V. Mukhina
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0002-8145-7023
Evgeniya V. Mukhina - Junior Research Fellow, Department of Neurology.
61/2 Shchepkina ul., Moscow, 129110.
РоссияReferences
- Puccioni-Sohler M. Cerebrospinal fluid oligoclonal IgG bands in multiple sclerosis: what does it mean? Arq Neuropsiquiatr. 2012;70(8):569-570. doi: 10.1590/s0004-282x2012000800001.
- Kira JI. Unexpected exacerbations following initiation of disease-modifying drugs in neuromyelitis optica spectrum disorder: Which factor is responsible, anti-aquaporin 4 antibodies, B cells, Th1 cells, Th2 cells, Th17 cells, or others? Mult Scler. 2017;23(9):1300-1302. doi: 10.1177/1352458517703803.
- Ramanathan S, Dale RC, Brilot F. Anti-MOG antibody: The history, clinical phenotype, and pathogenicity of a serum biomarker for demyelination. Autoimmun Rev. 2016;15(4): 307-324. doi: 10.1016/j.autrev.2015.12.004.
- Mariotto S, Ferrari S, Monaco S, Benedetti MD, Schanda K, Alberti D, Farinazzo A, Capra R, Mancinelli C, De Rossi N, Bombardi R, Zuliani L, Zoccarato M, Tanel R, Bonora A, Turatti M, Calabrese M, Polo A, Pavone A, Grazian L, Sechi G, Sechi E, Urso D, Delogu R, Janes F, Deotto L, Cadaldini M, Bianchi MR, Cantalupo G, Reindl M, Gajofatto A. Clinical spectrum and IgG subclass analysis of anti-myelin oligodendrocyte glycoprotein antibody-associated syndromes: a multicenter study. J Neurol. 2017;264(12):2420-2430. doi: 10.1007/s00415-017-8635-4.
- Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302. doi: 10.1002/ana.22366.
- Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-1452. doi: 10.1212/wnl.33.11.1444.
- Wassmer E, Chitnis T, Pohl D, Amato MP, Banwell B, Ghezzi A, Hintzen RQ, Krupp LB, Makhani N, Rostasy K, Tardieu M, Tenem-baum S, Waldman A, Waubant E, Kornberg AJ. International Pediatric MS Study Group Global Members Symposium report. Neurology. 2016;87(9 Suppl 2):S110-S116. doi: 10.1212/WNL.0000000000002880.
- Wang CX, Greenberg BM. Pediatric Multiple Sclerosis: From Recognition to Practical Clinical Management. Neurol Clin. 2018;36(1):135-149. doi: 10.1016/j.ncl.2017.08.005.
- Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology. 2002;59(8):1224-1231. doi: 10.1212/wnl.59.8.1224.
- Токарева ЮВ, Котов АС, Пантелеева МВ, Бунак МС. Расстройства из спектра оптиконевромиелита у пациентов детского возраста. Неврология, нейропсихиатрия, психосоматика. 2018;10(1):60-64. doi: 10.14412/20742711-2018-1-60-64.
- Бойко АН, Быкова ОВ, Сиверцева СА. Рассеянный склероз у детей и подростков. М.: Медицинское информационное агентство; 2016. 408 с.