Susceptibility-weighted imaging in the differential diagnosis of autoimmune central nervous system vasculitis and multiple sclerosis

Publication date: Available online 23 May 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Xuehong Huang, Tingting Lu, Zhuoxin Guo, Lei Wei, Shaoqiong Chen, Wei Qiu, Zhengqi LuAbstractObjectivesTo determine the differentiating features of autoimmune central nervous system (CNS) vasculitis and multiple sclerosis (MS) on susceptibility-weighted imaging (SWI).MethodsSeventy-three patients (27 with autoimmune CNS vasculitis and 46 with MS) who underwent magnetic resonance imaging with SWI sequence were included. The features of lesions and distinct SWI findings were investigated in both diseases.ResultsOn SWI, autoimmune CNS vasculitis presented with a higher prevalence of multiple microbleeds (48.1%), cortical superficial siderosis (70.4%), and tortuosity of the vascular route (59.3%) than were found in MS (p
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research

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Conclusions: Seizures and encephalopathy are not rare in MOG encephalomyelitis, and are commonly associated with cortical and subcortical brain lesions. MOG-encephalomyelitis often presents with clinical meningoencephalitis symptoms and abnormal CSF findings mimicking central nervous system infection in pediatric and young adult patients. Background Immunoglobulin-G against myelin oligodendrocyte glycoprotein (MOG-IgG) is considered a potential demyelinating disease-associated autoantibody. Previous experimental studies have established MOG-IgG as a pathogenic antigen rather than an epiphenomenal bystander or a secon...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions OCB are important biomarkers that can support MRI diagnostics and help to avoid false-positive MS diagnoses. Therefore, the revised McDonalds criteria have increased the importance of the OCB. New biomarkers such as AQP4 have now established themselves in clinical practice, and others such as Anti-MOG and NfL are about to enter clinical routine. An important focus in the search for new biomarkers is the monitoring of therapy efficacy and the prediction of severe side effects. Many other CSF molecules such as CHI3L1, IL-6, or CXCL13 show potential as markers for clinical practice, but further research is nee...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
This study was provided by the Canadian Institutes of Health Research and the Manitoba Health Research Council. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References 1. Sprent J, Kishimoto H. The thymus and central tolerance. Philos Trans R Soc Lond B Biol Sci. (2001) 356:609–16. doi: 10.1098/rstb.2001.0846 PubMed Abstract | CrossRef Full Text | Google Scholar 2. Sakaguchi S, Wing K, Miyara M. Regulatory T cells - a brief history and perspective. ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsIn the presence of concurrent immune-mediated diseases, the diagnosis of MS can be challenging. This clinical presentation posed significant difficulties in disease management, influencing therapeutic options and their effectiveness/adverse effects profile. The best approach in MS patients with concurrent autoimmune diseases remains to be established and more reports are needed to help clarify this subject.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Alemtuzumab is a highly effective therapy for relapsing-remitting MS (RRMS) with secondary autoimmunity as a main adverse event. Here, we present a case of microscopic polyangiitis (MPA) in a patient with RRMS secondary to alemtuzumab therapy.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: All Immunology, Autoimmune diseases, Vasculitis, Multiple sclerosis Clinical/Scientific Notes Source Type: research
Conclusions Our case of GFAPα IgG-associated encephalitis along with 12 other cases of serious inflammatory brain disorders following daclizumab treatment so far indicates that interfering with NK cells and Tregs by anti-CD25 antibody therapy can result in severe secondary CNS autoimmunity in man.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Autoimmune diseases, Multiple sclerosis Article Source Type: research
In 2012, a 33-year-old woman was diagnosed with relapsing-remitting MS (RRMS) after fulfilling McDonald criteria and careful exclusion of other differential diagnoses. Five years later (EDSS 1), she changed her disease-modifying therapy after side effects to betaferon (flu-like symptoms) and dimethyl fumarate (erythema and pruritus) to daclizumab. Two months after 2 applications of 150 mg daclizumab, she developed a self-limiting rash (figure 1A), followed by fever, headaches, meningismus, photophobia, nausea, paraesthesia, and itching of her upper body 1 month later. Blood test showed decreased lymphocyte counts...
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Autoimmune diseases, Vasculitis, Critical care, Multiple sclerosis Clinical/Scientific Notes Source Type: research
We present a case of 66-year-old female patient who has been treated by both conventional and Chinese traditional medicine after diagnosis was confirmed in 2008 as MS and antiphospholipid syndrome associated with CNS vasculitis. After diagnosis with clinical image confirmed with CT and MRI scan, where demyelinating zones were present, she started pharmacological therapy without major improvement. Patient suffered with fatigue, walking difficulties, weakness, was unable to articulate due to vocal cords spasms. We started acupuncture treatment in 2010 with herbal supplement therapy as well and patient had in total of 19...
Source: Neuroendocrinology Letters - Category: Endocrinology Tags: Neuro Endocrinol Lett Source Type: research
Conclusions: Recurrent ON occurs in association with MOG antibodies distinct from neuromyelitis optica and multiple sclerosis, and may require steroid-based immunosuppression to maintain remission. This case report from South Asia adds to map the worldwide occurrence of MOG antibody disease.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
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