Pediatric multiple sclerosis

Despite its relative rarity, pediatric multiple sclerosis (MS) is an important entity, as it provides unique insights into disease processes related to MS. Clinical, MRI and laboratory data suggest differences in the immune response and CNS environment between adults and children with MS. Yeh et al...

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Vydané v:Nature reviews. Neurology Ročník 5; číslo 11; s. 621 - 631
Hlavní autori: Yeh, E. Ann, Chitnis, Tanuja, Krupp, Lauren, Ness, Jayne, Chabas, Dorothée, Kuntz, Nancy, Waubant, Emmanuelle
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London Nature Publishing Group UK 01.11.2009
Nature Publishing Group
Predmet:
Accreditation
Adolescent
Adult
Adults
Age
Age Factors
Care and treatment
Child
Children
Demographic aspects
Demographics
Diagnosis
Diagnosis, Differential
Disease Progression
Disease Susceptibility
Diseases
Encephalomyelitis
Environment
Female
Genetic aspects
Herpesvirus 4, Human - physiology
Humans
Magnetic Resonance Imaging - methods
Male
Medical education
Medicine
Medicine & Public Health
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - epidemiology
Multiple Sclerosis - etiology
Multiple Sclerosis - therapy
Neurology
North America - epidemiology
Pathogenesis
Pediatrics
Randomized Controlled Trials as Topic
review-article
Sex Factors
North America
United States
United States > US
ISSN:1759-4758, 1759-4766, 1759-4766
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Shrnutí:Despite its relative rarity, pediatric multiple sclerosis (MS) is an important entity, as it provides unique insights into disease processes related to MS. Clinical, MRI and laboratory data suggest differences in the immune response and CNS environment between adults and children with MS. Yeh et al . provide a comprehensive overview of the pediatric MS field, including epidemiology, disease mechanisms, diagnosis and treatment. Pediatric multiple sclerosis (MS) accounts for up to 5% of all MS cases. Work conducted over the past 5 years has provided new information about the treatment, pathogenesis, demographics, and natural history of this disorder. Genetic and environmental factors seem to exert critical influences on its development. Clinical, MRI and laboratory data from prepubertal and postpubertal children suggest differences between the immune response and/or CNS environment in younger compared with older children and adults with MS. Randomized, controlled treatment trials for pediatric MS have not yet been performed, but therapies used in adult MS have been evaluated in this population, and their use seems to be safe. This article provides a comprehensive review of current knowledge regarding pediatric MS, highlighting new advances in the field. Key Points Pediatric multiple sclerosis (MS) represents ∼3–4% of all cases of MS In North America, greater diversity in ethnicity, race and ancestry is observed among individuals with pediatric MS than among adults with MS, possibly reflecting changing demographic trends Studies have suggested environmental influences on pediatric MS susceptibility, including Epstein–Barr virus and exposure to cigarette smoke Acute disseminating encephalomyelitis must be differentiated from MS and is seen more commonly in children than in adults New MRI criteria will, hopefully, help to discriminate pediatric MS from acute disseminated encephalomyelitis Currently available first-line therapies for adults with MS seem to be safe and well tolerated in pediatric MS
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ISSN:1759-4758
1759-4766
1759-4766
DOI:10.1038/nrneurol.2009.158