scholarly journals Infectious and Noninfectious Granulomatosis in Patient with Multiple Sclerosis: Diagnostic Dilemmas and Followup

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Jelena Paovic ◽  
Predrag Paovic ◽  
Vojislav Sredovic
Keyword(s):  
Multiple Sclerosis ◽  
Immune System ◽  
Pulmonary Tuberculosis ◽  
Cataract Surgery ◽  
Systemic Infection ◽  
Neurological Manifestations ◽  
Initial Attack ◽  
Mri Findings ◽  
Retrobulbar Neuritis ◽  
Preoperative Procedures

Patient was followed up over the course of 30 years. In 1978, after severe systemic infection followed by fever, pulmonary edema, and numerous neurological manifestations, patient was differentially diagnosed with apoplectic form of multiple sclerosis (MS), which was confirmed a year later via neurological and MRI findings. Approximately 20 years following the initial attack, sarcoidosis was diagnosed during the regular preoperative procedures required for cataract surgery. As consequence of lower immune system, infectious granulomatosis in form of pulmonary tuberculosis developed. Ophthalmological findings revealed bilateral retrobulbar neuritis (RBN) approximately six years after initial attack. This developed into total uveitis with retinal periphlebitis and anterior granulomatous uveitis—all of which are clinically similar in both MS and sarcoidosis.

A CAD system for assessment of MRI findings to track the progression of multiple sclerosis

2007 ◽  
Author(s):  
Alexis Wong ◽  
Arkadiusz Gertych ◽  
Chi-Shing Zee ◽  
Bing Guo ◽  
Brent J. Liu
Keyword(s):  
Multiple Sclerosis ◽  
Mri Findings ◽  
Cad System

T1 hypointense lesion load in secondary progressive multiple sclerosis: a comparison of pre versus post contrast loads and of manual versus semi automated threshold techniques for lesion segmentation

1998 ◽  
Vol 4 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J I O'Riordan ◽  
M Gawne Cain ◽  
A Coles ◽  
L Wang ◽  
D AS Compston ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Strong Correlation ◽  
Measurement Techniques ◽  
Progressive Multiple Sclerosis ◽  
Secondary Progressive Multiple Sclerosis ◽  
Lesion Volume ◽  
Mri Findings ◽  
Lesion Load ◽  
Post Contrast ◽  
Secondary Progressive

Magnetic resonance imaging (MRI) is increasingly being used as a monitoring tool for disease activity in therapeutic trials in multiple sclerosis. There is, however, only a limited relationship between MRI findings and clinical outcome measurements. It has been suggested that hypointense lesion load on T1 weighted imaging has a better correlation with disability than the more conventional T2 hyper intense lesion load. This study was undertaken to (i) evaluate different measurement techniques used to quantify T1 hypointense lesion load, and (ii) to compare lesion load as measured using different parameters and disability. Twenty-five patients with secondary progressive multiple sclerosis, mean age of 40 years (23-57), mean EDSS 5.7 (4-7) were analysed. T2 lesion load on FSE correlated well with both the hypointense lesion load on T1 pre-gadolinium (r=0.8, P50.0001) and T1 post-gadolinium (r=0.8, P50.0001) but less so with the enhancing lesion load (r=0.4, P50.05). There was a very strong correlation with T1 hypo-intense lesion volume pre and post gadolinium (r=0.96, P50.001). However, the EDSS was not correlated with the T2 lesion load (r=70.27, P=0.2), T1 pre-gadolinium load (r=70.3, P=0.1), T1 post gadolinium load (r=70.4, P=0.7) and enhancing lesion load (r=70.28, P=0.2), or with the degree of hypointensity of T1 weighted images determined using the threshold technique. There is a strong correlation between T1 hypointense lesion volume both pre and post gadolinium and also between T1 and T2 lesion volumes.

FEATURES OF THE CLINICAL COURSE OF RETROBULBAR NEURITIS

Vestnik ◽  
2021 ◽  
pp. 296-298
Author(s):  
Т.С. Телеуова ◽  
Ж.Б. Меерманова ◽  
Ф.Е. Жумагельдиева ◽  
А.Е. Каиров ◽  
А.Д. Мендыбаева ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Picture ◽  
Clinical Course ◽  
Retrobulbar Neuritis

В данной статье представлена особенности клинической картины ретробульбарного неврита вследствие рассеянного склероза. This article presents the features of the clinical picture of retrobulbar neuritis due to multiple sclerosis.

scholarly journals Cyclophosphamide Versus Rituximab in Progressive Forms of Multiple Sclerosis

2020 ◽  
Author(s):  
Masoud Etemadifar ◽  
Shadi Ghourchian ◽  
Nazanin Mahinparvar ◽  
Mehri Salari ◽  
Fatemeh Etemadifar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
The Other ◽  
Medical Sciences ◽  
Mri Findings ◽  
Disability Score ◽  
Radiologic Findings ◽  
Spss Software ◽  
And Gender

This study aimed to compare the efficacy of rituximab versus Cyclophosphamide on active secondary progressive multiple sclerosis (SPMS). The randomized clinical trial was performed from 2015 to 2017 in multiple sclerosis (MS) clinics affiliated to Isfahan MS society (IMSS). Patients were randomized to two groups, and one of them received Rituximab that was repeated every six months in case of medical indication. The other one received a monthly pulse of methylprednisolone plus cyclophosphamide (Endoxan, Baxter, UK) until two years. Expanded disabilities status scale (EDSS), clinical, and MRI findings were assessed every six months. Statistical analysis was performed using SPSS software. 39 patients in the Rituximab group and 30 in the Cyclophosphamide group with similar age and gender distribution were entered for analysis. At baseline, the mean number of attacks in the Rituximab group was significantly more than the Cyclophosphamide group (P=0.0001). After 6, 12, and 18 months of treatment, the rate of attacks was similar between groups although it increased significantly in the Rituximab group (P=0.030) after 24 months of treatment. EDSS was increased in the Rituximab group more than the other group at the end of the study. Both drugs were well-tolerated by patients. The EDSS was increased in the Rituximab group but the disability score did not worsen in the Cyclophosphamide group. Both therapies were associated with a reduction in disease attacks and improvement in radiologic findings in a two-year period of follow-up. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(8):484-491.

scholarly journals Pathogenesis and Treatment of Cytokine Storm Induced by Infectious Diseases

2021 ◽  
Vol 22 (23) ◽  
pp. 13009
Author(s):  
Xi-Dian Tang ◽  
Tian-Tian Ji ◽  
Jia-Rui Dong ◽  
Hao Feng ◽  
Feng-Qiang Chen ◽  
...  
Keyword(s):  
Immune System ◽  
Infectious Diseases ◽  
Targeted Therapies ◽  
Tissue Damage ◽  
Systemic Infection ◽  
Therapeutic Strategies ◽  
Targeted Treatment ◽  
Cytokine Storm ◽  
Pathophysiological Mechanisms ◽  
Circulating Cytokines

Cytokine storm is a phenomenon characterized by strong elevated circulating cytokines that most often occur after an overreactive immune system is activated by an acute systemic infection. A variety of cells participate in cytokine storm induction and progression, with profiles of cytokines released during cytokine storm varying from disease to disease. This review focuses on pathophysiological mechanisms underlying cytokine storm induction and progression induced by pathogenic invasive infectious diseases. Strategies for targeted treatment of various types of infection-induced cytokine storms are described from both host and pathogen perspectives. In summary, current studies indicate that cytokine storm-targeted therapies can effectively alleviate tissue damage while promoting the clearance of invading pathogens. Based on this premise, “multi-omics” immune system profiling should facilitate the development of more effective therapeutic strategies to alleviate cytokine storms caused by various diseases.

Correlation of MRI findings and neuropsychological results in patients with multiple sclerosis

1989 ◽  
Vol 29 (3) ◽  
pp. 293-294 ◽  
Author(s):  
U. Mann ◽  
D. Staedt ◽  
L. Kappos ◽  
A.V.D. Wense ◽  
I. Haubitz
Keyword(s):  
Multiple Sclerosis ◽  
Mri Findings

Discrepancies in the interpretation of clinical symptoms and signs in the diagnosis of multiple sclerosis. A proposal for standardization

2005 ◽  
Vol 11 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Bernard MJ Uitdehaag ◽  
Ludwig Kappos ◽  
Lars Bauer ◽  
Mark S Freedman ◽  
David Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Clinical Findings ◽  
Large Trial ◽  
Mri Findings ◽  
Mcdonald Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Eligibility Assessment

The new McDonald diagnostic criteria for multiple sclerosis (MS) incorporate detailed criteria for the interpretation and classification of magnetic resonance imaging (MRI) findings, but, in contrast, provide no instructions for the interpretation of clinical findings. Because MS according to the McDonald criteria is one of the primary endpoints in a large trial enrolling patients after the first manifestation suggestive for a demyelinating disease (BENEFIT study), it was decided to organize a centralized eligibility assessment for this trial. During this eligibility assessment it was observed that there were marked inconsistencies in the decisions of participating neurologists with respect to the classification of clinical symptoms as being caused by one or more lesions provoking discussions in about one in every five patients. This paper describes these inconsistencies and their sources, and recommends a systematic approach that attempts to reduce the variability in interpreting clinical findings.

Vaccination opportunities in multiple sclerosis patients treated with cladribine tablets

2021 ◽  
Vol 20 ◽  
Author(s):  
Lucia Moiola ◽  
Agostino Riva ◽  
Ferdinando Nicoletti ◽  
Antonio Uccelli ◽  
Marco Salvetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Immune System ◽  
Mechanism Of Action ◽  
Vaccination Campaign ◽  
Humoral Response ◽  
Focused Attention ◽  
Vulnerable Patients ◽  
Mass Vaccination Campaign ◽  
Multiple Sclerosis Patients ◽  
Vaccination Campaigns

: The COVID-19 pandemic and the mass vaccination campaign highlighted the situation of the most vulnerable patients. In this work, we focused attention on patients who have Multiple Sclerosis (MS), particularly in treatment with cladribine tablets, trying to understand if and when it is possible to administer the vaccine successfully. Considering the innovative topic, we reviewed the existing literature with an analysis of the experiences also related to other vaccinations, including influenza and VZV, and very recent data from countries with vaccination campaigns already advanced. Overall, we have taken into account the mechanism of action, the pharmacokinetic/pharmacodynamic of cladribine and the changes in the immune system after its administration, together with the preliminary data about the humoral response to influenza, VZV and SARS-CoV-2 vaccinations in cladribine treated patients. In conclusion, data showed that the use of cladribine tablets seems to permit flexibility regarding vaccination timing and we suggest that vaccination in those patients should be safe and effective.

Bilateral fingolimod-associated macular oedema development after cataract surgery

2021 ◽  
Vol 14 (6) ◽  
pp. e240562
Author(s):  
Matthew Gillam ◽  
Theresa Richardson
Keyword(s):  
Multiple Sclerosis ◽  
Cataract Surgery ◽  
Macular Oedema ◽  
Topical Therapy ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Visual Recovery ◽  
Anti Inflammatory

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.

The case of posterior ischemic optic neuropathy in patient with multiple sclerosis

2021 ◽  
pp. 107-110
Author(s):  
T.N. Kiseleva ◽  
◽  
E.K. Eliseeva ◽  
M.N. Zakharova ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Blood Flow ◽  
Optic Neuropathy ◽  
Internal Carotid ◽  
Duplex Sonography ◽  
Ischemic Optic Neuropathy ◽  
Color Duplex Sonography ◽  
Retrobulbar Neuritis ◽  
Posterior Ischemic Optic Neuropathy ◽  
Brachiocephalic Arteries

A case of posterior ischemic optic neuropathy (PION) in a 41-year-woman with 19 years remission of multiple sclerosisis presented.She had complaints of acute unilateral loss of vision and underwent complex clinical and instrumental examination including B-scan of orbit, color duplex sonography (CDS) of orbital vessels and brachiocephalic arteries, magnetic resonance imaging (MRI). The significant stenosis of internal carotid artery due to its dissection was detected on the affected eye side. The results of ultrasound examinations and MRI excluded demyelinative retrobulbar neuritis (RBN) and determined the signs of blood flow impairment in vessels of orbital part of the optic nerve. Differential diagnostics of PION and RBN required the investigations of blood flow in orbital vessels and brachiocephalic arteries. Key words: posterior ischemic optic neuropathy, multiple sclerosis, retrobulbar neuritis, color duplex sonography, internal carotid artery.

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