Contributions
Abstract: EP1306
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS Variants
Multiple sclerosis (MS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are both demyelinating autoimmune disorders of the nervous system with unknown underlying pathomechanism. Whereas MS is restricted to the central nervous system, CIDP comprises demyelination of the peripheral nervous system. There are a few reports in the literature about patients suffering from both, CNS and PNS manifestation in similar extent.
In this case series, we describe ten patients showing a heterogeneous clinical spectrum with primary central nervous system or peripheral nervous system involvement and a monophasic or chronic disease course. Mean age was 55.9±10.8 years, without sex preference. Disease duration was 14.4± 7.6 years. Seventy per cent of the patients developed central demyelination before peripheral disease with fulfilled diagnostic criteria for MS according to McDonald criteria. However, oligoclonal bands were positive in only five patients (50%), elevated protein was found in 80% of the patients. In contrast, demyelinating criteria for CIDP according to the European Federation of neurological society (EFNS) was fulfilled in only 30%. Interestingly, only the minority of patients suffered from a high lesion load (40%) and had a progressive disease course (10%) with a mean EDSS Score of 4.0 (2.5-6.5), whereas course for neuropathy was progressive despite ongoing treatment in 40 %. In contrast to previous publications, some of the patients described here became stabilized under a monotreatment of regular IVIG treatment for long-term whereas others need a combination of different immunmodulatory treatment regimens. So far tested, paranodal antibodies had not been detected in this cohort (in progress).Taken together, in this case series patients suffered from a moderate and non-progressive course of multiple sclerosis when additionally affected by peripheral demyelination. However, sufficient treatment of concomitant demyelinating neuropathy may become a challenge over the course of disease.
Disclosure: Klehmet received personal compensation for speaker fees and advosiry boards from Grifols, CSL Behring, Octapharma, Novartis.
Haas received personal compensation for speaker fees and advosiry boards from Novartis, Sanofi Genzyme, HOFFMANN La Roche, Biogen, Teva, Merck, Bayer.
Abstract: EP1306
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS Variants
Multiple sclerosis (MS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are both demyelinating autoimmune disorders of the nervous system with unknown underlying pathomechanism. Whereas MS is restricted to the central nervous system, CIDP comprises demyelination of the peripheral nervous system. There are a few reports in the literature about patients suffering from both, CNS and PNS manifestation in similar extent.
In this case series, we describe ten patients showing a heterogeneous clinical spectrum with primary central nervous system or peripheral nervous system involvement and a monophasic or chronic disease course. Mean age was 55.9±10.8 years, without sex preference. Disease duration was 14.4± 7.6 years. Seventy per cent of the patients developed central demyelination before peripheral disease with fulfilled diagnostic criteria for MS according to McDonald criteria. However, oligoclonal bands were positive in only five patients (50%), elevated protein was found in 80% of the patients. In contrast, demyelinating criteria for CIDP according to the European Federation of neurological society (EFNS) was fulfilled in only 30%. Interestingly, only the minority of patients suffered from a high lesion load (40%) and had a progressive disease course (10%) with a mean EDSS Score of 4.0 (2.5-6.5), whereas course for neuropathy was progressive despite ongoing treatment in 40 %. In contrast to previous publications, some of the patients described here became stabilized under a monotreatment of regular IVIG treatment for long-term whereas others need a combination of different immunmodulatory treatment regimens. So far tested, paranodal antibodies had not been detected in this cohort (in progress).Taken together, in this case series patients suffered from a moderate and non-progressive course of multiple sclerosis when additionally affected by peripheral demyelination. However, sufficient treatment of concomitant demyelinating neuropathy may become a challenge over the course of disease.
Disclosure: Klehmet received personal compensation for speaker fees and advosiry boards from Grifols, CSL Behring, Octapharma, Novartis.
Haas received personal compensation for speaker fees and advosiry boards from Novartis, Sanofi Genzyme, HOFFMANN La Roche, Biogen, Teva, Merck, Bayer.