Clinical course, pathological correlations, and outcome of biopsy proved inflammatory demyelinating disease
Clinical course, pathological correlations, and outcome of biopsy proved inflammatory demyelinating disease
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DOI：
10.1136/jnnp.2004.060624
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发表时间：
2005-12-01
影响因子：
11
通讯作者：
Lucchinetti, CF
中科院分区：
文献类型：
--
作者：
Pittock, SJ;McClelland, RL;Lucchinetti, CF
背景资料：已经发展了早期活动性多发性硬化（MS）病变的病理学分类，其揭示了四种组织损伤模式：I-T细胞/巨噬细胞相关; II -抗体/补体相关; III -远端少突胶质细胞病，和IV -斑块周围白色物质中的少突胶质细胞变性.早期MS的脱髓鞘机制可能在亚组之间存在差异。以往对活检MS的研究缺乏临床病理相关性和随访。批评者认为，观察结果不能推广到原型MS。目的：描述MS病变项目活检队列的临床病理学特征。方法：经病理证实的炎性脱髓鞘病患者的临床特点及致残情况（不包括ADEM）进行免疫病理学分类（n = 91）和来自奥姆斯特德县MS患病队列的患者结果：大多数经活检病理证实的脱髓鞘疾病患者最终发展为明确的（n = 70）或可能的（n = 12）MS（中位随访时间4.4年）。大多数有复发缓解过程，73%是门诊（EDSS
Background: A pathological classification has been developed of early active multiple sclerosis ( MS) lesions that reveals four patterns of tissue injury: I - T cell/macrophage associated; II - antibody/ complement associated; III - distal oligodendrogliopathy, and IV - oligodendrocyte degeneration in the periplaque white matter. Mechanisms of demyelination in early MS may differ among the subgroups. Previous studies on biopsied MS have lacked clinicopathological correlation and follow up. Critics argue that observations are not generalisable to prototypic MS.Objective: To describe the clinicopathological characteristics of the MS Lesion Project biopsy cohort.Methods: Clinical characteristics and disability of patients with pathologically confirmed inflammatory demyelinating disease ( excluding ADEM) classified immunopathologically ( n = 91) and patients from the Olmsted County MS prevalence cohort ( n = 218) were determined.Results: Most patients who underwent biopsy and had pathologically proved demyelinating disease ultimately developed definite ( n = 70) or probable ( n = 12) MS ( median follow up 4.4 years). Most had a relapsing remitting course and 73% were ambulatory (EDSS