多发性硬化症患儿鞘内 IgM 合成和 MRZ 反应的频率

IF 2.3 3区 医学 Q3 CLINICAL NEUROLOGY European Journal of Paediatric Neurology Pub Date : 2024-04-16 DOI:10.1016/j.ejpn.2024.04.005
S. Chen , Bertolini A , G. Koukou , E.M. Wendel , C. Thiels , M. Baumann , C. Lechner , A. Blaschek , A. Della Marina , G. Classen , B. Stüve , B. Kauffmann , T. Kapanci , B. Mayer , M. Otto , K. Rostásy
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引用次数: 0

摘要

背景多发性硬化症(MS)是一种中枢神经系统慢性炎症性脱髓鞘疾病。鞘内 IgM 合成与多发性硬化症的快速进展以及对麻疹、风疹和水痘带状疱疹病毒(MRZR)的鞘内免疫反应有关,如果存在这种反应,则会增加成人多发性硬化症诊断的可能性。方法符合条件的多发性硬化症患儿,其数据集包括临床和治疗史、发病时的核磁共振成像、脑脊液分析以及麻疹、风疹和带状疱疹抗体指数(AI)的测定。结果 在 75 名多发性硬化症患儿中,93.3% 的患儿存在 OCBs。)49.2%的患儿在6个月内首次复发。50.7%的患儿在首次脑部核磁共振成像中发现的病灶总数超过10个。64%的患者有脊柱病变。23.5%的患者 MRZR 呈阳性,40.3%的患者鞘内 IgM 合成呈阳性。结论 在部分多发性硬化症儿童中发现了鞘内 IgM 合成和 MRZR 阳性,但这与预后不良的相关指标无关。
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Frequency of an intrathecal IgM synthesis and MRZ reaction in children with MS

Background

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the CNS. An intrathecal IgM synthesis is associated with a more rapid progression of MS and the intrathecal immune response to measles -, rubella -and varicella zoster virus (MRZR) which, if present, increases the likelihood of a diagnosis of MS in adults.

Objective

To evaluate the frequency of an intrathecal IgM synthesis and MRZR in children with MS.

MethodsChildren with MS and a data set including clinical and treatment history, MRI at onset, in addition to a CSF analysis, and determination of antibody index (AI) of measles, rubella, and zoster antibodies, were eligible. The presence of an intrathecal IgM synthesis and/or a positive MRZ reaction were compared to biomarkers of a more progressive disease course.

Results

In 75 children with MS, OCBs were present in 93.3 %). 49,2 % experienced their first relapse within 6 months. 50.7 % had a total lesion load of more than 10 lesions in the first brain MRI. Spinal lesions were identified in 64 %. 23.5 % had a positive MRZR and 40.3 % an intrathecal IgM synthesis. No significant associations were detected between the presence of an intrathecal IgM synthesis and MRZR and parameters including the relapse rate in the first two years.

Conclusion

An intrathecal IgM synthesis and a positive MRZR are found in a subset of MS children but are not associated with markers associated with a poor prognosis.

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来源期刊
CiteScore
6.30
自引率
3.20%
发文量
115
审稿时长
81 days
期刊介绍: The European Journal of Paediatric Neurology is the Official Journal of the European Paediatric Neurology Society, successor to the long-established European Federation of Child Neurology Societies. Under the guidance of a prestigious International editorial board, this multi-disciplinary journal publishes exciting clinical and experimental research in this rapidly expanding field. High quality papers written by leading experts encompass all the major diseases including epilepsy, movement disorders, neuromuscular disorders, neurodegenerative disorders and intellectual disability. Other exciting highlights include articles on brain imaging and neonatal neurology, and the publication of regularly updated tables relating to the main groups of disorders.
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