Esclerose múltipla: correlação clínico-laboratorial

Abstract

RESUMO -Aspectos clínicos e demográficos de 86 pacientes com o diagnóstico de esclerose múltipla (EM) forma clinicamente definida foram comparados aos achados do líquido cefalorraqueano. Do grupo total 30% encontrava-se em surto, 41% em remissão e 29% na forma crônica progressiva. Os pacientes com a forma crônica progressiva apresentavam índice de IgG sugestivo de imunoliberação intratecal em 76% dos casos, enquanto que aumento deste parâmetro foi observado em apenas 46% e 49%, das formas em surto e remissão, respectivamente (p<0,005). Os dados obtidos no estudo quantitativo da síntese intratecal de IgG contribuem para a demonstração de diferenças imunológicas entre ambas as formas de EM, surto-remissão e crônica progressiva. O uso de corticóides reduz quantitativamente a síntese intratecal de IgG mas não a síntese de bandas oligoclonais.PALAVRAS-CHAVE: esclerose múltipla, líquido cefalorraqueano, bandas oligoclonais, focalização isoelétrica.Multiple sclerosis: clinical and laboratorial correlation ABSTRACT -The clinical and demographic characteristics of 86 Brazilian patients with clinically definite multiple sclerosis (MS) were compared to the cerebrospinal fluid (CSF) findings. The disease course was relapsingremitting in 71% and chronic progressive in 29% of the cases. The IgG index was increased in 76% in the chronic progressive status and 46% and 49% during the bout and remission, respectively (p < 0.005). Only 36% of the MS patients using corticosteroids had increased IgG index, in comparison to the 64% of the patients without immunosupressive treatment. Oligoclonal IgG bands were detected in the CSF of 77% and 88% of the MS corticosteroids users and non-users, respectively. The quantitative study of intrathecal synthesis of IgG contributes to demonstrate the immunological differences between the two forms of MS, the relapsingremitting and the chronic progressive. The treatment with corticosteroids decreases quantitatively the intrathecal synthesis of IgG but not the presence of oligoclonal bands.

Study of oligoclonal bands restricted to the cerebrospinal fluid in multiple sclerosis patients in the city of São Paulo

“…The frequency of OCB found in this study is low in comparison with both the prevalence observed in European and North-America MS patients and other previous Brazilian studies which found a frequency of 85% 17 and 91% 18 . However, this low rate is similar to that observed in other regions of the world (Table 4).…”

The Use of Dance in the Rehabilitation of a Patient with Multiple Sclerosis

“…The main symptoms are fatigue, pain, spasticity, sensitive and motor dysfunctions, sexual and bladder dysfunctions, as well as cognitive impairments, and signs of depression. Less common are bowel dysfunction, paroxysmal symptoms, and symptoms pertinent to bipolar disorder (Campston, 2004;Feyes et al, 2004;Mendes, Tilbery, Balsimelli, Moreira, & Barão-Cruz, 2003;Mendes, Tilbery, & Felipe, 2000;Minguetti, 2001;Puccioni-Soher, Lavrado, Bastos, Brandão, & Papaiz-Alvarenga, 2001;Reder, 2004;Sadiq & Miller, 1997).…”

“…Currently, the diagnosis is determined by laboratory analysis, exams of somatosensory evoked potentials, and magnetic resonance imaging Poser & Brinar, 2004;Puccioni-Soher et al, 2001;Sadovnick, 2004;Sastre-Garriga et al, 2004).…”

Esclerose múltipla: aspectos nutricionais e o papel dos nutrientes específicos

“…As formas menos comuns são a progressiva primária e a progressiva em surtos, com comprometimentos contínuos desde o início da doença (40-60 anos). Somente a forma progressiva em surtos tem discreta remissão, com ou sem alguma recuperação (COMITÊ BRASILEIRO DE TRATAMENTO E PESQUISA DA ESCLEROSE MÚLTIPLA, 2005a, 2005bFERREIRA et al, 2004;PUCCIONI-SOHLER et al, 2001;SÁ, 2004).…”