Patterns and significance of concomitant central and peripheral inflammatory demyelination

Spinal cord involvement in chronic inflammatory demyelinating polyradiculoneuropathy: a clinical and MRI study

Concomitant central nervous system (CNS) involvement in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is rare. Although the spinal nerve roots may present MRI abnormalities in CIDP, hitherto, the spinal cord has been investigated in a single study. We retrospectively investigated clinically and with MRI a cohort of patients with definite CIDP diagnosis (EFNS/PNS criteria) for evidence of brain and spinal cord involvement, who were initially admitted in our department during the last 4 years. Among 12 patients with CIDP (men: 8, mean age: 59.3 years, mean disease duration: 3.8 years), nine patients had their MRI scan during a clinical relapse and three during remission. Brain MRI did not document typical multiple sclerosis lesions in any patient. We did not identify any MRI abnormalities in ten patients without clinical evidence of spinal cord involvement. Conversely, MRI disclosed extensive lesions of the thoracic cord in two patients with an overt spinal cord syndrome, whom we describe. This represents the biggest MRI study of CIDP patients who have been investigated for spinal cord involvement. Our data support earlier observations that a minority of CIDP patients may additionally develop CNS involvement of variable degree.

Central Nervous System Demyelination in a Charcot-Marie-Tooth Type 1A Patient

Introduction. Central nervous system involvement, either clinical or subclinical, has been reported mainly in X-linked Charcot-Marie-Tooth (CMT-X) patients. Case Presentation. We present the case of a 31-year-old man with a genetically confirmed history of CMT1A who developed CNS involvement mimicking multiple sclerosis (MS). Clinical, imaging, and laboratory findings suggested an autoimmune CNS demyelination. Discussion. Although the simultaneous existence of CMT1A and MS could be coincidental we postulate that overexpression of PMP22, the target protein in CMT1A, might influence the immunological self-tolerance to CNS proteins via molecular mimicry, leading to a CNS autoimmune demyelinating disorder.

Linkage of multiple sclerosis and guillain-barre syndrome: a population-based survey in isfahan, iran

Background. Multiple Sclerosis (MS) and Guillain Barre Syndrome (GBS) are autoimmune demyelinating disorders of Central and Peripheral Nervous system, respectively. The coexistence of these two syndromes in an individual's life span is rare. Objectives. To inspect throughout Isfahan MS society (IMSS) records for MS cases who had history of documented GBS whether before the onset of MS or after it. Methods. This retrospective survey was carried out by analyzing the clinical records of 3,522 MS patients who were registered with IMSS, from April 2003 to July 2010. Eligible cases were requested to attend to IMSS for final clinical/paraclinical examinations. Results. Among 3,522 (2,716 women and 806 men) MS subjects, we could identify seven patients (six females and one male) with documented diagnosis of GBS. Six patients (five women and one man) had developed MS within 6.5 ± 7.0 (range: 1–16) years after being diagnosed with GBS and one (a woman) had developed GBS three years after the diagnosis of MS. Conclusion. It seems that the development of MS in individuals with history of GBS is more than a simple incidental event.

Passive Transfer of Experimental Autoimmune Neuritis by IL-12 and IL-18 Synergistically Potentiated Lymphoid Cells is Regulated by NKR-P1+ Cells

The aim of this study was to investigate the roles and mechanism of interleukin-12 (IL-12) and interleukin-18 (IL-18) in potentiating the autoreactivity of lymphoid cells specific for P2 53-78 peptide. P2 53-78-specific lymphoid cells in the presence of IL-12 or IL-18 alone passive transferred only moderate experimental autoimmune neuritis (EAN) into a low percentage of recipients. However, lymphoid cells co-cultured with both cytokines transferred aggressive clinical and histological EAN into all recipients. NKR-P1+ cells (including NK and NKT cells) played an immunosuppressive function in passive transfer EAN and depletion of NKR-P1+ cells by anti-NKR-P1 Ab and complement induced a more serious form of EAN. Nevertheless, lymphoid cells co-cultured with both IL-12 and IL-18 induced high levels of interferon-gamma (IFN-gamma) and promoted Th1 differentiation partially through NKR-P1+ cells and to some extent, NKR-P1+ cell depletion inhibited the auto-reactivity of lymphoid cells treated with IL-12 and IL-18.