The search for an ideal multiple sclerosis biomarker with good diagnostic value, prognostic reference and an impact on clinical outcome has yet to be realized and is still ongoing. The aim of this review is to establish an overview of the frequent biomarkers for multiple sclerosis that exist to date. The review summarizes the results obtained from electronic databases, as well as thorough manual searches. In this review the sources and methods of biomarkers extraction are described; in addition to the description of each biomarker, determination of the prognostic, diagnostic, disease monitoring and treatment response values besides clinical impact they might possess. We divided the biomarkers into three categories according to the achievement method: laboratory markers, genetic-immunogenetic markers and imaging markers. We have found two biomarkers at the time being considered the gold standard for MS diagnostics. Unfortunately, there does not exist a single solitary marker being able to present reliable diagnostic value, prognostic value, high sensitivity and specificity as well as clinical impact. We need more studies to find the best biomarker for MS.
Background and Objective: Axional tissue impairment playes a substantial role in the development of disability in multiple sclerosis.[...]
Background. The therapy of patients with concomitant multiple sclerosis and ankylosing spondylitis is a challenge for clinicians. Secukinumab has been shown to be effective in the treatment of multiple sclerosis. In the clinical case we present, substantial clinical and radiological remission in the case of both autoimmune diseases was observed. Case presentation. A male adult was diagnosed with relapsingremitting multiple sclerosis. The patient complained of severe thoraco-lumbar pain. Magnetic resonance imaging led to a diagnosis of ankylosing spondylitis. Considering that nonsteroidal anti-inflammatory drugs were ineffective and TNF-alfa blockers are contraindicated in patients with multiple sclerosis, secukinumab was prescribed. Magnetic resonance imaging 8 months after initiation of therapy provided clinical stability in consideration of the two autoimmune comorbidities. Conclusions. Secukinumab is an effective therapy of concomitant multiple sclerosis and ankylosing spondylitis.
Introduction: Scleroderma is a rare heterogeneous multisystem autoimmune disease. The disease is characterized by structural abnormalities of the small blood vessels. Scleroderma affects all organs of the body. Skin manifestations are commonly reported, but peripheral nervous system (PNS) and central nervous system (CNS) involvement has been less frequently reported. Neurological manifestations are broad, and it is challenging for clinicians to confirm a diagnosis of scleroderma. Case Presentation: In our case, a 53-year-old white woman had extensive clinical presentations: skin rashes and symptoms from internal organs, CNS, and PNS during the previous 11 years. She had not undergone any specific treatment because diagnosis has not been made in the early stages. Conclusion: It is important to make the diagnosis as early as possible and start treatment with immunomodulatory and immunosuppressant medication, as it affects the patient's disease progression, quality of life, and mortality. A detailed medical history, physical examination, and laboratory and radiology findings help us to identify and diagnose scleroderma. But unfortunately, it was late, and the patient died. This case guides us to be more careful and make the diagnosis of scleroderma earlier in the future.
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