scholarly journals Double Filtration Plasmapheresis Treatment of Refractory Multiple Sclerosis Relapsed on Fingolimod: A Case Report

2020 ◽  
Vol 10 (21) ◽  
pp. 7404
Author(s):  
Roberto De Masi ◽  
Stefania Orlando ◽  
Salvatore Accoto
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Improvement ◽  
Gamma Globulin ◽  
Neurological Diseases ◽  
Methyl Prednisolone ◽  
Double Filtration Plasmapheresis ◽  
First Case ◽  
Double Filtration ◽  
Steroid Refractory ◽  
Inflammatory Effect

Double filtration plasmapheresis (DFPP) is an emerging semi-selective apheretic method for treating immuno-mediated neurological diseases. Here we report the first case of steroid-refractory relapsed multiple sclerosis (MS) on Fingolimod (FTY), treated effectively by this technique, in a 37-year-old woman. This condition is thought to be caused by soluble inflammatory species, but its demyelinating pattern is unknown; moreover, despite megadoses of intravenous 6-methyl prednisolone, it induces severe neurological deterioration, but dramatically responded to DFPP in our patient. The clinical improvement was driven by a strong DFPP-induced anti-inflammatory effect, with significant reduction of C3/C4 components, total gamma globulin concentrations (IgG), and gamma-fibrinogen (FGG), resulting in a brain pseudoatrophy phenomenon. Our findings are: first, the steroid-refractory relapsed MS on FTY, however serious, can be treated with DFPP; second, given the good clinical improvement due to the DFPP-induced neuroinflammatory components removal, this clinical condition can be associated with a Lucchinetti pattern II of demyelination.

(University of Pennsylvania Case Conference): oligoclonal immunoglobulins in cerebrospinal fluid in multiple sclerosis.

1980 ◽  
Vol 26 (9) ◽  
pp. 1340-1345 ◽  
Author(s):  
A A Keshgegian ◽  
J Coblentz ◽  
R P Lisak
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Gamma Globulin ◽  
Neurological Diseases ◽  
Broad Band ◽  
Lymphoproliferative Disorders ◽  
University Of Pennsylvania ◽  
Case Conference ◽  
Monoclonal Immunoglobulins ◽  
The Many

Abstract In the normal state, immunoglobulins are polyclonal. They migrate as a broad band on electrophoresis, reflecting the diversity of immunoglobulin species secreted by the many clones of immunoglobulin-producing cells. In lymphoproliferative disorders, monoclonal immunoglobulins are often found, migrating as electrophoretically homogeneous bands, reflecting the large amount of a single immunoglobulin being secreted by the single proliferating neoplastic clone. In certain neurological diseases, such as multiple sclerosis, the cerebrospinal fluid (CSF)2 often exhibits an oligoclonal immunoglobulin pattern consisting of several electrophoretically homogeneous bands in the gamma-globulin regin (Figure 1). We present two cases of neurological disease with an oligoclonal immunoglobulin pattern in the CSF electropherogram. In the discussion we consider the definition, etiology, and pathogenesis of multiple sclerosis, and laboratory tests that are useful in multiple sclerosis, emphasizing methods for the demonstration and interpretation of an oligoclonal immunoglobulin pattern.

A Case Report of Double Filtration Plasmapheresis in an Acute Episode of Multiple Sclerosis

2008 ◽  
Vol 12 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Alfonso Ramunni ◽  
Francesca De Robertis ◽  
Paola Brescia ◽  
Maria Teresa Saliani ◽  
Michele Amoruso ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Acute Episode ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

Therapeutic efficacy of double filtration plasmapheresis in patients with anti-aquaporin-4 antibody-positive multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 478-480 ◽  
Author(s):  
Masashi Munemoto ◽  
Yoshinaga Otaki ◽  
Shuhei Kasama ◽  
Masayoshi Nanami ◽  
Masanori Tokuyama ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Therapeutic Efficacy ◽  
Aquaporin 4 ◽  
Positive Multiple ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration ◽  
Aquaporin 4 Antibody

scholarly journals Ultra-high-field 7-T MRI in multiple sclerosis and other demyelinating diseases: from pathology to clinical practice

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Nicolo’ Bruschi ◽  
Giacomo Boffa ◽  
Matilde Inglese
Keyword(s):  
Multiple Sclerosis ◽  
High Field ◽  
Neurological Diseases ◽  
Lesion Detection ◽  
Demyelinating Diseases ◽  
Metabolic Imaging ◽  
Central Vein ◽  
Ultra High Field ◽  
Functional Features

Abstract Magnetic resonance imaging (MRI) is essential for the early diagnosis of multiple sclerosis (MS), for investigating the disease pathophysiology, and for discriminating MS from other neurological diseases. Ultra-high-field strength (7-T) MRI provides a new tool for studying MS and other demyelinating diseases both in research and in clinical settings. We present an overview of 7-T MRI application in MS focusing on increased sensitivity and specificity for lesion detection and characterisation in the brain and spinal cord, central vein sign identification, and leptomeningeal enhancement detection. We also discuss the role of 7-T MRI in improving our understanding of MS pathophysiology with the aid of metabolic imaging. In addition, we present 7-T MRI applications in other demyelinating diseases. 7-T MRI allows better detection of the anatomical, pathological, and functional features of MS, thus improving our understanding of MS pathology in vivo. 7-T MRI also represents a potential tool for earlier and more accurate diagnosis.

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