The relationship between multiple sclerosis and the state of the human microbiome was studied, namely, the change in the representation of microbiota phylotypes, the proportion of coccal flora, the proportion of anaerobic, gram-negative, proteolytically active microflora, as well as the concentration of markers of bacterial plasmalogen and endotoxin in the blood. Microbiome studies were carried out by gas chromatography - mass spectrometry of microbial markers in the blood. A statistically significant increase in blood concentrations of the total level of microbial markers of bacterial plasmalogen and endotoxin was determined in multiple sclerosis, which may be associated with an increase in the permeability of the intestinal wall. In multiple sclerosis, the proportion of coccal, gram-negative, anaerobic microflora with a proteolytic type of metabolic activity increases. The correlations of the representation of microbiota phylotypes change due to the switching of the direct relationship Proteobacteria-Bacteroides to Proteobacteria-Firmicutes. In multiple sclerosis, Actinobacteria and Proteobacteria increase and Firmicutes decrease. Conclusion. The multiple sclerosis disease may be associated with pathological changes in the structure of the microbiome and the growth of endotoxemia, which may be one of the factors in the pathogenesis of the disease. New laboratory markers for diagnosing and predicting the course of MS have been proposed.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an uncommon disease characterized by heterogeneous clinical findings, absence of specific laboratory markers and good response to treatment. Typically CIDP manifests as weakness of varying severity, from minimal paresis to plegia, as well as symmetrical loss of sensitivity in all limbs, a distinctive clinical feature of CDL is the involvement of both proximal and distal parts of extremities. At the same time, there is a large number of atypical CIDP variants, clinically similar to other chronic disimmune neuropathies. Neuroimaging findings typically include involvement of the cauda equina, brachial, and lumbar plexus. The patient sought medical help complaining of weakness and loss of sensation in the extremities. This clinical case illustrates a combined involvement of cranial and spinal nerves, as well as spinal cord and brain in a patient with chronic inflammatory demyelinating polyneuropathy.
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