Pediatric Central Nervous System Demyelinating Diseases.
Pediatric Central Nervous System Demyelinating Diseases.
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DOI：
10.1212/con.0000000000000730
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发表时间：
2019-06-01
期刊：
影响因子：
--
通讯作者：
Chitnis, Tanuja
中科院分区：
文献类型：
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作者：
Chitnis, Tanuja
综述目的：本文对儿童脱髓鞘障碍的分类、诊断和治疗进行了最新的总结。研究结果：对儿童脱髓鞘障碍的不同谱系，包括单相型和多相型的理解有了提高。儿童多发性硬化症(MS)是儿童中最常见的脱髓鞘疾病，最近的遗传和环境风险研究表明，儿童多发性硬化症与成人多发性硬化症属于同一疾病连续体。儿童中髓鞘少突胶质细胞糖蛋白和水通道蛋白-4抗体的鉴定是一项重大进展，允许对这些综合征进行适当的治疗和管理。总结：抗体检测现在有助于确定儿童脱髓鞘疾病的亚型，包括髓鞘少突胶质细胞糖蛋白血清阳性和水通道蛋白-4血清阳性病例，这些病例与儿科MS不同。治疗儿童MS的治疗正在临床试验中进行评估。
PURPOSE OF REVIEW: This article provides an up-to-date summary of the categories, diagnosis, and management of pediatric demyelinating disorders.RECENT FINDINGS: Understanding of the diverse spectrum of pediatric demyelinating disorders, including monophasic and multiphasic forms, has improved. Pediatric multiple sclerosis (MS) is the most common demyelinating disorder in children, and recent genetic and environmental risk research has clarified that pediatric MS is on the same continuum of disease as adult MS. Recent advances in the treatment of pediatric MS include clinical trials leading to regulatory agency-approved treatments. The identification of myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies in children has been a major advance, allowing for appropriate treatment and management of these syndromes.SUMMARY: Antibody testing is now helping to define subtypes of pediatric demyelinating disorders, including myelin oligodendrocyte glycoprotein-seropositive and aquaporin-4-seropositive cases that are distinct from pediatric MS. Treatments for pediatric MS are being evaluated in clinical trials.