Cerebral demyelination in Wegener’s granulomatosis

Brinar, Vesna; Čikeš, Nada; Petelin, Željka; Hlavati, Marina; Poser, Charles M.

doi:10.1016/j.clineuro.2004.02.021

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…These mechanisms potentially result in CSF alterations (mild pleocytosis in 30%–40% [ 2 ] or elevated immunoglobulin G (IgG) indices in up to 75% [ 2 ], and MRI findings (inflammatory T2 lesions in 40% [ 3 ]) similar to those in MS patients. Thus, NPSLE can be difficult to distinguish from MS; this is also true for other rheumatologic disorders with CNS involvement (RDwCNS) such as primary vasculitides, including granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis) [ 4 , 5 ], microscopic polyangiitis (MPA) [ 6 ], and Behçet’s disease [ 7 ]. For several reasons the reliable differentiation between SLE and MS is important, at least because of significant differences in treatment regimens [ 2 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis

et al. 2018

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BackgroundSome rheumatologic disorders may initially manifest with central nervous system (CNS) affection, mimicking the clinical, magnetic resonance imaging, and cerebrospinal fluid findings of multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, has been found positive frequently in MS patients. However, it is unclear whether the MRZR is helpful to distinguish rheumatologic disorders with CNS involvement (RDwCNS) from MS.MethodsThe MRZR was evaluated in patients with RDwCNS (n = 23), MS (n = 46; age and sex matched to patients with RDwCNS), and other inflammatory autoimmune neurological diseases affecting the CNS (OIND; n = 48). Both the stringency levels that have been used in previous MRZR studies, MRZR-1 (≥ 1 of 3 AIs positive) and MRZR-2 (≥ 2 of 3 AIs positive), were applied.ResultsThere was no statistically significant difference in the prevalence of positive MRZR between patients with RDwCNS (MRZR-1: 13.0% and MRZR-2: 8.7%, respectively) and OIND (MRZR-1: 22.9% and MRZR-2: 8.3%, respectively). Compared to these two study cohorts, the MS group exhibited significantly higher prevalences of positive MRZR (MRZR-1: 82.6%, MRZR-2: 63.0%; p < 0.005 each).ConclusionsConsidering the high specificity of MRZR-2 for MS found in this study, MRZR-2 can be a useful diagnostic tool for distinguishing MS from RDwCNS or OIND.

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Section: Introductionmentioning

confidence: 99%

The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis

et al. 2018

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“…• In the lungs, macroscopically dispersed and localized necrotizing granulomas can be seen which may coalesce and from nodules which may ulcerate and cavitate (Brinar et al 2004). …”

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confidence: 97%

“…Patients with focal lesions can have hematuria and proteinuria which respond to treatment, whereas those with diffuse disease can rapidly develop progressive renal insufficiency (Brinar et al 2004;Cabral et al 2009). …”

mentioning

confidence: 98%