Clinical features and disease out come in patients with pediatric and young adult onset Multiple Sclerosis

PREGNANCIES MODIFY RELAPSES AND PROGRESSION IN MULTIPLE SCLEROSIS

Primary Progressive and progressive relapsing multiple sclerosis show different clinical and instrumental findings and disability progression? A comparison study on a Sicilian database

Clinical features, disease course and prognosis in patients with paediatric and young adult onset multiple sclerosis

Background. Multiple sclerosis (MS) patients develop their first symptoms before adolescence approximately in 5%. Studies comparing clinical and prognostic characteristics in early onset MS, did not show homogeneous results. Objective. Aim of this study was to investigate characteristics of early onset MS patients and compare them with patients who experienced MS onset later. Methods. MS patients diagnosed as affected by MS according to Poser's criteria, were included if they experienced symptoms onset before age 25. They were classified in three groups. Group A: patients who had their onset until they were 16 years old Group B: individuals with onset between 17 and 20 yearsGroup C: patient…

Real world experience with teriflunomide in multiple sclerosis: the TER-Italy study.

Objective: To identify baseline factors associated with disease activity in patients with relapsing–remitting multiple sclerosis (RRMS) under teriflunomide treatment. Methods: This was an independent, multi-centre, retrospective post-marketing study. We analysed data of 1,507 patients who started teriflunomide since October 2014 and were regularly followed in 28 Centres in Italy. We reported the proportions of patients who discontinued treatment (after excluding 32 lost to follow-up) and who experienced clinical disease activity, i.e., relapse(s) and/or confirmed disability worsening, as assessed by the Expanded Disability Status Scale (EDSS). Decision tree-based analysis was performed to i…

Hypoxanthine and purine compounds in plasma from patients with multiple sclerosis and psoriasis

Natalizumab Discontinuation and Treatment Strategies in Patients with Multiple Sclerosis (MS): A Retrospective Study from Two Italian MS Centers

Introduction Natalizumab (NTZ) discontinuation can be followed by multiple sclerosis (MS) disease reactivation. Currently no disease-modifying drug (DMD) has been shown to be able to abolish disease reactivation. The aims of the current study were: (1) to determine the frequency of MS reactivation after NTZ discontinuation; (2) to evaluate predictors of reactivation risk, and (3) to compare the effect of different treatments in reducing this risk. Methods Data from 132 patients with MS followed-up for 2 years before NTZ treatment and 1 year after interruption were collected from two Italian MS centers and retrospectively evaluated. Results Overall, 72 of 132 patients (54.5%) had relapses af…

IMMUNOSUPPRESSANT TREATMENT AND CANCER RISK IN A COHORT OF PATIENTS AFFECTED BY MULTIPLE SCLEROSIS

Association between multiple sclerosis, cancer risk, and immunosuppressant treatment: a cohort study

Abstract Background The association between multiple sclerosis (MS) and cancer has long been investigated with conflicting results. Several reports suggest an increased cancer risk among MS patients treated with immunosuppressant (IS) drugs. Methods We performed a cohort study including MS patients recruited at the Neurological Department of the University of Palermo. Mean follow-up period was ten years for the whole cohort. We calculated cancer incidence among patients treated with IS. Incidence rates were compared in the cohort by calculating the relative risk according to length and dose of exposure to IS. Cancer incidence among MS patients was compared to cancer incidence in the general…

Clinical and instrumental predictors of efficacy of natalizumab therapy in the course of multiple sclerosis: a retrospective study from a single centre

SIMULTANEOUS DETERMINATION OF ATP, ITS METABOLITES AND NAD+ IN BLOOD BY HPLC WITH PHOTODIODE ARRAY DETECTOR

SIMULTANEOUS DETERMINATION OF ATP, ITS METABOLITES AND NAD+ IN BLOOD BY HPLC WITH PHOTODIODE ARRAY DETECTOR Gueli Maria Concetta, Cusimano Vincenza, Lo Re Marianna, Giuseppe Salemi Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNEC), Università degli Studi di Palermo. Nucleotides are major high-energy phosphate carriers, subunits of nucleic acids and precursors for the synthesis of nucleotide cofactors such as NAD+ and SAM. The study of purine nucleotides metabolism is very important topic for a right understanding for the cellular life. Living cells rely on ATP for growth, differentiation, and response to physiological stimuli and environmental stress. We propose a fa…

Cyclophosphamide Pulse Therapy after Natalizumab Discontinuation for Multiple Sclerosis: a multicenter study.

Importance: Natalizumab discontinuation induces the recurrence of Multiple Sclerosis (MS) disease activity: Currently no therapeutic approach has been found able to abolish disease reactivation. Objective: To collect data from patients with MS switching from natalizumab to cyclophosphamide. Design: Retrospective multicentre study. Setting: Nine Multiple Sclerosis Centers in Italy. Participants: A total of 47 patients with clinically definite RR-MS switched to cyclophosphamide after natalizumab discontinuation. Two patients were excluded from the analysis because received less than 12 natalizumab infusions. The remaining 45 patients were subdivided into two main groups: Early Treatment (peri…

Reversible posterior leukoencephalopathy syndrome in a patient with thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder characterised by fever, microangiopathic haemolytic anaemia, renal insufficiency, and thrombocytopenia. Neurological involvement, a prominent component of TTP, is characterised by a variety of brain lesions which include reversible cerebral oedema or magnetic resonance imaging (MRI) features of reversible posterior leukoencephalopathy syndrome (RPLS). TTP is frequently associated with deficiency of the von Willebrand factor-cleaving protease, ADAMTS13.Here, we report a case of TTP with severe acute encephalopathy. Posterior leukoencephalopathy and brainstem oedema with triventricular hydrocephalus were observed on MRI. The …

Return of disease activity after natalizumab therapy discontinuation in patients with multiple sclerosis: frequency and clinical and instrumental predictors of reactivation

Causes and place of death in Italian patients with amyotrophic lateral sclerosis

Objectives - To determine the causes and place of death in a cohort of Italian patients with amyotrophic lateral sclerosis (ALS). A better understanding of the likely causes of death in ALS might improve the palliative care at the end-of-life, whereas knowing the place of death will help to verify the need for highly specialized care services, e.g. hospice and nursing home. Patients and methods - Between 2000 and 2008, 182 ALS patients (onset: spinal, 127; bulbar, 55; M/F: 1.6) were followed in a single ALS Tertiary Centre in Palermo, Sicily, Italy until death. Medical data for each individual patient were recorded in a large database throughout the disease course. Information concerning ca…

Extracellular vesicles isolated by cerebrospinal fluid as biomarkers of inflammation in multiple sclerosis and inflammatory neurological diseases.

Clinical and Instrumental Findings and Disability Progression in Primary Progressive and Progressive Relapsing Multiple Sclerosis: A Comparison Study of a Sicilian Group of Patients

Purine metabolism and multiple sclerosis: pattern varies according to disease stage and clinical form

Clinical and instrumental predictors of efficacy of Natalizumab therapy in multiple sclerosis patients: a retrospective study from a single centre

Frequency of John Cunningham virus (JCV) DNA and of antibodies against JCV in patients affected by multiple sclerosis and their relationship with natalizumab therapy

Purine metabolism and Multiple Sclerosis: different pattern according to different disease stage and different clinical form.

P422 Purine metabolism and multiple sclerosis: pattern varies according to disease stage and clinical form G. Salemi, M. Gueli, V. Cusimano, M. Lo Re, V. Lo Re, M.A. Mazzola, S. Realmuto, P. Ragonese, G. Savettieri University (Palermo, IT) Background: Serum concentration of uric acid (sUA) was variably associated with Multiple Sclerosis (MS). Many papers reported lower sUA in MS patients respect to healthy controls, expecially in course of relapse. This lower sUA was considered as a marker of oxidative stress. However, this association was not confirmed by many other papers. Recently, an increase in the concentration of sUA, hypoxanthine, xanthine, and sum of oxypurine (sPU) was reported in…

A CASE OF JUVENILE STROKE CAUSED BY ACTINIC CERVICAL ARTERIOPATHY

Introduction: Radiation Arteriopathy is a vascular disease characterized by progressive arterial stenosis that may occur after external radiotherapy (RT) directed to a specific body region affected by malignant tumours. The arterial damage usually starts many years after the injury and the specific pathogenesis is unknown, though atherosclerosis praecox, endothelial damage, adventitial fibrosis and vasa vasorum obliteration are likely involved mechanisms. In patients with previously irradiated neck or head cancers, supra aortic arteries can be affected in their segments exposed to radiations leading to a gradual lumen narrowing. This late complication leads to a progressive stenosis of extr…