scholarly journals Methylprednisolone-induced hepatotoxicity in a 16-year-old girl with multiple sclerosis

2018 ◽  
Vol 11 (1) ◽  
pp. e226687 ◽  
Author(s):  
Eleonora Rotondo ◽  
Alessandro Graziosi ◽  
Vincenzo Di Stefano ◽  
Angelika Anna Mohn
Keyword(s):  
Multiple Sclerosis ◽  
Chronic Inflammatory Disease ◽  
High Dose ◽  
First Line Therapy ◽  
Elevated Liver Enzymes ◽  
High Dose Methylprednisolone ◽  
The Central Nervous System ◽  
High Doses ◽  
Hepatocyte Necrosis ◽  
New Diagnosis

Multiple sclerosis (MS) is a chronic inflammatory disease with demyelination of the central nervous system. High-dosage corticosteroids are the first-line therapy in the acute relapsing of MS. We report a case of severe high-dose methylprednisolone-induced acute hepatitis in a patient with a new diagnosis of MS. A 16-year-old girl was admitted for urticaria, angioedema, nausea and vomiting a month later she had been diagnosed with MS and treated with high-dosage methylprednisolone. Laboratory investigations showed hepatic insufficiency with grossly elevated liver enzymes. A liver biopsy showed focal centrilobular hepatocyte necrosis with interface hepatitis. Methylprednisolone-induced hepatotoxicity can confuse the clinical picture of patients with MS and complicate the differential diagnosis. We believe that each specialist should know it and monitor patients with MS taking high doses of methylprednisolone. As there is no screening model that predicts idiosyncratic hepatotoxicity, we promote screening for potential liver injury following pulse steroid therapy.

scholarly journals Validation and cross-cultural adaptation of sexual dysfunction modified scale in multiple sclerosis for Brazilian population

2015 ◽  
Vol 73 (8) ◽  
pp. 681-687 ◽  
Author(s):  
Raquel Ataíde Peres da Silva ◽  
Guilherme Sciascia do Olival ◽  
Lívia Palma Stievano ◽  
Vania Balardin Toller ◽  
Sergio Semeraro Jordy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Cultural Adaptation ◽  
Chronic Inflammatory Disease ◽  
Cross Cultural ◽  
Brazilian Population ◽  
Control Group ◽  
Cross Cultural Adaptation ◽  
The Central Nervous System ◽  
The Impact

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). These patients suffer from various comorbidities, including sexual dysfunction (SD). The lesions of MS may affect regions of the CNS along the pathway of sexual response. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a scale that assesses sexual dysfunction. Adapt and validate the MSISQ-19 to Brazilian patients with MS. 204 individuals were evaluated, 134 patients with MS and 70 healthy persons for the control group. It was determined reproducibility, validity, internal consistency and sensitivity of the MSISQ-19-BR. Among patients with MS, 54.3% of male and 71.7% of female presented some kind of SD. In the control group the results were 12.5% and 19.5%, respectively. The MSISQ-19-BR is reproducible, reliable and valid for the Brazilian population and may be used as a tool for assessing the impact of sexual dysfunction in patients with MS.

scholarly journals Modeling Resilience to Damage in Multiple Sclerosis: Plasticity Meets Connectivity

2019 ◽  
Vol 21 (1) ◽  
pp. 143 ◽  
Author(s):  
Mario Stampanoni Bassi ◽  
Ennio Iezzi ◽  
Luigi Pavone ◽  
Georgia Mandolesi ◽  
Alessandra Musella ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Synaptic Plasticity ◽  
Network Architecture ◽  
White Matter Lesions ◽  
Long Term Potentiation ◽  
Chronic Inflammatory Disease ◽  
Brain Network ◽  
Term Potentiation ◽  
The Central Nervous System ◽  
Efficient Information

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by demyelinating white matter lesions and neurodegeneration, with a variable clinical course. Brain network architecture provides efficient information processing and resilience to damage. The peculiar organization characterized by a low number of highly connected nodes (hubs) confers high resistance to random damage. Anti-homeostatic synaptic plasticity, in particular long-term potentiation (LTP), represents one of the main physiological mechanisms underlying clinical recovery after brain damage. Different types of synaptic plasticity, including both anti-homeostatic and homeostatic mechanisms (synaptic scaling), contribute to shape brain networks. In MS, altered synaptic functioning induced by inflammatory mediators may represent a further cause of brain network collapse in addition to demyelination and grey matter atrophy. We propose that impaired LTP expression and pathologically enhanced upscaling may contribute to disrupting brain network topology in MS, weakening resilience to damage and negatively influencing the disease course.

IFN-β treatment modulates the CD28/CTLA-4-mediated pathway for IL-2 production in patients with relapsing -remitting multiple sclerosis

2004 ◽  
Vol 10 (6) ◽  
pp. 630-635 ◽  
Author(s):  
C Espejo ◽  
L Brieva ◽  
G Ruggiero ◽  
J Río ◽  
X Montalban ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Chronic Inflammatory Disease ◽  
Autoimmune Response ◽  
T Cell Proliferation ◽  
Immunomodulatory Effects ◽  
Cd25 Expression ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Relapsing Remitting Multiple Sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system probably mediated by Th1 lymphocytes. IFN-b is an established therapy for relapsing MS patients, although the mechanisms underlying its efficacy are yet to be well characterized. We determined IL-2 production, CD25 expression and T-cell proliferation from relapsing -remitting MS patients before and three months after starting therapy. A decrease in the percentage of CD80-induced IL-2-producing cells was observed after in vivo IFN-b treatment. These data support that one of the immunomodulatory effects of IFN-b treatment in MS may be a limitation of the autoimmune response modifying the CD80:CD28/CTLA-4 pathway.

Corticosteroids and Multiple Sclerosis: To Treat or Not to Treat?

2005 ◽  
Vol 138 (6) ◽  
pp. 1-13 ◽  
Author(s):  
Mike Namaka ◽  
Carol St-Laurent ◽  
Raelene Vandenbosch ◽  
Ranbir Gill ◽  
Dana Ruhlen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Prevalence Rate ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Decision Making Process ◽  
High Dose ◽  
High Prevalence Rate ◽  
Autoimmune Pathology ◽  
High Prevalence ◽  
The Central Nervous System

Although a rare disease, multiple sclerosis (MS) has a high prevalence rate in Canada and affects many Canadians and their families. An autoimmune disease of the central nervous system, it results in the destruction of the myelin sheath that surrounds the nerve axons. High-dose IV steroid therapy is often used to treat an acute exacerbation in MS. Steroids have immunosuppressant effects that work to decrease the autoimmune pathology component of the disease and to reduce the inflammation around the nerve axon, thereby promoting closer contact of the damaged myelin and subsequently partially restoring adequate electrical nerve conduction to reduce symptoms. The high prevalence rate of MS in Canada makes it vital for pharmacists to become more aware of the different aspects of the disease and how these relate to therapy. The pharmacist should be aware of the adverse effects and impact of high-dose IV steroids in MS patients. The purpose of this review is threefold: 1) to provide a better understanding of MS pathology; 2) to contribute a systematic review of steroids; and 3) to assist in the clinical decision-making process and in the counselling requirements for patients on high-dose steroids.

Myelin reactive T cells in the autoimmune pathogenesis of multiple sclerosis

1998 ◽  
Vol 4 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Piet Stinissen ◽  
Robert Medaer ◽  
Jef Raus
Keyword(s):  
Multiple Sclerosis ◽  
T Cells ◽  
T Cell ◽  
T Cell Responses ◽  
Chronic Inflammatory Disease ◽  
Current Evidence ◽  
Central Position ◽  
Cell Responses ◽  
The Central Nervous System ◽  
Myelin Antigens

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) leading to demyelination. Although it is widely accepted that demyelination in MS results from an active inflammatory process, the cause of the inflammation is still not completely resolved. Findings in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, and observations in human MS have led to the hypothesis that MS is an autoimmune disease mediated by autoreactive T cells with specificity for myelin antigens. The identity of the brain antigen(s) which is (are) the primary target(s) of the autoimmune process is not known, but current evidence indicates that myelin basic protein (MBP) is a likely candidate. In this paper we will overview some of the experimental evidence suggesting that MBP reactive T cells hold a central position in the pathogenesis of MS, and discuss some of the currently tested therapeutic strategies in MS which are directed towards the pathogenic MBP reactive T cells. Although there appears to be no direct correlation between anti-MBP T cell responses and clinical disease activity, some recent observations suggest that monitoring of anti-MBP T cell responses could be helpful to study immunological efficacy of experimental immunotherapies in MS.

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