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

Rostásy, Kevin; Reiber, Hansotto

doi:10.1017/s0924270800032646

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…A positive MRZ reaction in the CSF has not been reported in association with anti-NMDAR antibody encephalitis. The MRZ reaction only rarely occurs in NMO10 and its presence allows to differentiate MS from ADEM 11. CXCL13 is a B-lymphocyte-attractant chemokine that has been shown to correlate with the clinical course of MS, and with the presence of intrathecal IgG synthesis and of a positive MRZ reaction 8.…”

Section: Discussionmentioning

confidence: 99%

Periventricular white matter lesion and incomplete MRZ reaction in a male patient with anti-N-methyl-d-aspartate receptor encephalitis presenting with dysphoric mania

et al. 2015

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Several findings suggest that there may be an overlap of anti-N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis with neuromyelitis optica spectrum disorders or acute demyelinating encephalomyelitis (ADEM)-like demyelination. We present a case of a patient with anti-NMDAR antibody encephalitis, who on MRI featured a single prominent T2-hyperintensive white matter lesion in the periventricular region, adjacent to the anterior horn of the left lateral ventricle. In view of the lesion location and the cerebrospinal fluid (CSF) findings (incomplete MRZ (measles, rubella and varicella zoster) reaction, lymphocytic pleocytosis, intrathecal IgG and IgM synthesis; absence of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies), the presence of a multiple sclerosis-like immune response was discussed. This case appears to add evidence to the hypothesis of an overlap between anti-NMDAR antibody encephalitis and other inflammatory central nervous system diseases.

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Section: Discussionmentioning

confidence: 99%

Periventricular white matter lesion and incomplete MRZ reaction in a male patient with anti-N-methyl-d-aspartate receptor encephalitis presenting with dysphoric mania

et al. 2015

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“…The different traditions in different countries and the different judgements about the relevance of CSF analysis in the context of other clinical or imaging methods led to a wide spectrum of acknowledgement for CSF analysis. In case of infectious, acute neurological diseases (1,2) or in case of multiple sclerosis (3,4) with a chronic inflammatory process there is no controversy about the relevance of CSF analysis in Neurology (including analysis of CSF/serum quotients QAlb, QIgG, QIgA, QIgM, cell count, oligoclonal IgG and specific antibodies). But what about psychiatric diseases or dementive processes in brain, brain trauma, autoimmune diseases with involvement of the brain?…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal fluid analysis for diagnosis of noninflammatory, dementive and psychiatric diseases

Reiber

Otto

Bechter

2009

Acta Neuropsychiatr.

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CSF analysis contributes to differential diagnosis of noninflammatory diseases by: 1) exclusion of a chronic or acute inflammation. 2) detection of particular brain-derived proteins, surrogate markers, corresponding to the suggested diagnosis (tumor, dementia, brain hypoxia, hemorrhage, autoimmune disease, psychiatric disease, metabolic disorder, rhinorhea, Table 1) and 3. differential cell count in CSF. Interpretation of brain-derived proteins in CSF uses absolute concentrations (in contrast to CSF/serum quotients for blood-derived proteins) and must discriminate between different sources: Neuronal or glial proteins like NSE, or tau protein are evaluated using their absolute concentrations in CSF for maximal sensitivity without reference to QAlb. The leptomeningeal proteins like beta trace or cystatin C are evaluated as absolute concentrations with reference to QAlb. As application examples we review the group of dementive and psychiatric diseases. Alzheimer's disease, Parkinson's disease dementia, Lewy-body disease and frontotemporal dementia are the major causes of neurodegenerative memory impairment and dementia. Combined analysis of Tau-Protein and Beta Amyloid 1-42 in CSF represent the classic approach, meanwhile extended with further surrogate markers. In 15% of psychiatric patients with schizophrenic or affective disorders an inflammatory process could be detected which points to a brain-organic involvement. In 24% of these patients with a psychiatric disease a moderately increased albumin quotient was observed as the only unexplained pathological sign. In psychiatric diseases it has to be regarded as a serious deficit not to make at least once a CSF analysis in the patients which could modify the diagnosis (in 6%).

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Collection and Analyses of Cerebrospinal Fluid for Pediatric Translational Research

Cameron

Gillio-Meina

Ranger

et al. 2019

Pediatric Neurology

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

Cited by 3 publications

References 12 publications

Periventricular white matter lesion and incomplete MRZ reaction in a male patient with anti-N-methyl-d-aspartate receptor encephalitis presenting with dysphoric mania

Periventricular white matter lesion and incomplete MRZ reaction in a male patient with anti-N-methyl-d-aspartate receptor encephalitis presenting with dysphoric mania

Cerebrospinal fluid analysis for diagnosis of noninflammatory, dementive and psychiatric diseases

Collection and Analyses of Cerebrospinal Fluid for Pediatric Translational Research

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