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Clinical and neurochemical characteristics of pediatric multiple sclerosis – CSF analysis as knowledge base for differential diagnosis and pathophysiology

Published online by Cambridge University Press:  24 June 2014

Kevin Rostasy  and
Hansotto Reiber
Kevin Rostasy
Affiliation:
Department of Pediatrics IV, Division of Pediatric Neurology, Inborn Errors of Metabolism and Developmental Neurology, Medical University of Innsbruck, Innsbruck, Austria
Hansotto Reiber
Affiliation:
Neurochemistry Laboratory, Department of Neurology, Georg-August University Göttingen, Germany
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Abstract:

Multiple sclerosis (MS) is the most common chronic inflammatory disease of the central nervous system affecting young adults. Although adults and children share important features of the disease, they also differ in some clinical, radiological and laboratory aspects. This review focuses on the neuroimmunological findings in the cerebrospinal fluid of children with MS pointing out that there is already at earliest time of clinical manifestation a neuroimmunological pattern, which differs only in intensity of the humoral immune response but not in frequency and does not support a neuroimmunological difference between early onset from adult onset MS. The humoral immune response with intrathecal IgG and IgM class response and the polyspecific production of antibodies against a wide range of antigens (MRZ antibody response) further helps to differentiate childhood MS from ADEM as the main differential diagnostic challenge.

Type
Main Theme: Multiple Sclerosis
Information
Acta Neuropsychiatrica , Volume 21 , Issue S2: Special Issue: Abstracts of 49th Neuropsychiatric Pula Congress, 17-20 June 2009, Pula, Croatia , June 2009 , pp. 20 - 21
Copyright
Copyright © 2009 John Wiley & Sons A/S

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References

References:

1.Amato, MP, Ponziani, G, Bartolozzi, ML, Siracusa, G. A prospective study on the natural history of multiple sclerosis: clues to the conduct and interpretation of clinical trials. J Neurol Sci 1999;168:96–106.CrossRefGoogle Scholar
2.Simone, IL, Carrara, D, Tortorella, C, Liguori, M, Lepore, V, Pellegrini, F, Bellacosa, A, Ceccarelli, A, Pavone, I, Livrea, P. Course and prognosis in early-onset MS. Comparison with adult-onset forms. Neurology 2002;59:1922–1928.CrossRefGoogle ScholarPubMed
3.Renoux, C, Vukusic, S, Mikaeloff, Y, et al.The natural history of MS with Childhood onset. NEMJ 2007;356:2603–2613.CrossRefGoogle Scholar
4.Noseworthy, JH, Lucchinetti, C, Rodriguez, M, Weinshenker, BG. Multiple sclerosis. N Engl J Med 2000;343:938–952.CrossRefGoogle ScholarPubMed
5.Pohl, D, Hennemuth, J, von Kries, R, Hanefeld, F. Pediatric Multiple Sclerosis and Acute Disseminated Encephalomyelitis in Germany: Results of a nationswide survey. Eur J Pediatr 2007;166:405–412.CrossRefGoogle Scholar
6.Gorman, MP, Healy, BS, Polgar-Turcsanyi, M, Chitnis, T. Increased Relapse Rate in Pediatric-Onset compared With Adult-Onset Multiple Sclerosis. Arch Neurol 2009;66:54–59.CrossRefGoogle ScholarPubMed
7.Hahn, CD, Shroff, MM, Blaser, SI, Banwell, BL. MRI criteria for multiple sclerosis. Evaluation in a pediatric cohort. Neurology 2004;62:806–808.Google ScholarPubMed
8.Reiber, H, Ungefehr, S, Jacobi, C. The intrathecal, polyspecific and oligoclonal immune response in multiple sclerosis. Mult Scler 1998;4:111–117.CrossRefGoogle ScholarPubMed
9.Reiber, H, Peter, JB. Cerebrospinal fluid analysis – disease-related data patterns and evaluation programs. J Neurol Sci 2001;184:101–122.CrossRefGoogle ScholarPubMed
10.Reiber, H. Basic CSF diagnostic in neuroimmunological diseases. Acta Neuropsychiatrica 2008;20(S1):9–10.Google Scholar
11.Reiber, H, Albaum, W. Statistical evaluation of intrathecal protein synthesis in CSF/Serum quotient diagrams. Acta Neuropsychiatrica 2008;20(S1):48–49. Free download of the CSF Statistics Tool from www.COMED-com.de.Google Scholar
12.Villar, LM, Masjuan, J, González-Porqué, P, Plaza, J, Sádaba, MC, Roldán, E, Bootello, A, Alvarez-Cermeño, JC. Intrathecal IgM synthesis predicts the onset of new relapses and a worse disease course in MS. Neurology 2002;59:555–559.CrossRefGoogle Scholar
13.Villar, LM, Masjuan, J, Gonzalez-Porque, P, Plaza, J, Sádaba, MC, Roldán, E, Bootello, A, Alvarez-Cermeño, JC. Intrathecal IgM synthesis is a prognostic factor in multiple sclerosis. Ann Neurol 2003;53:222–226.CrossRefGoogle ScholarPubMed
14.Sharief, MK, Thompson, EJ.Intrathecal immunglobulin M synthesis in multiple sclerosis. Brain 1991;114:181–195.Google Scholar