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Abstract

The present report describes immunopathological, radiologcal and serological characteristics of antibody-mediated demyelination in a multiple sclerosis (MS) case with the main findings: (1) immunoglobulin and complement deposits in areas of active demyelination accompanied by massive macrophage activation; (2) ring-enhancing lesions in T1-weighted MRI after gadolinium application; (3) high titers of serum anti-myelin antibodies; and (4) signs of macrophage activation in the serum. Plasmapheresis may be a successful treatment for the type of inflammatory demyelination shown in the present case.

Keywords

Multiple sclerosis antibody plasmapheresis

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References

Lucchinetti CF et al. (1996) Distinct patterns of Multiple Sclerosis pathology indicates heterogeneity in pathogenesis . Brain Pathol 6: 259-274 .

Linington C et al. (1992) Induction of persistently demyelinated lesions in the rat following the repeated adoptive transfer of encephalitogenic T cells and demyelinating antibody . J Neuroimmunol 40: 219-224 .

Linington C et al. (1988) Augmentation of demyelination in rat acute allergic encephalomyelitis by circulating mouse monoclonal antibodies directed against a myelin/oligodendrocyte glycoprotein . Am J Pathol 130: 443-454 .

Adelmann M et al. (1995) The N-terminal domain of the myelin oligodendrocyte glycoprotein (MOG) induces acute demyelinating experimental autoimmune encephalomyelitis in the Lewis rat . J Neuroimmunol 63: 17-27 .

Storch MK et al. (1998) Autoimmunity to myelin oligodendrocyte glycoprotein in rats mimics the spectrum of multiple sclerosis pathology . Brain Pathol 8: 681-694 .

Prineas JW , Graham JS. (1981) Multiple Sclerosis: capping of surface immunoglobulin G on macrophages engaged in myelin breakdown . Ann Neurol 10: 149-158 .

Storch MK et al. (1998) Multiple sclerosis: in situ evidence for antibody- and complement-mediated demyelination . Ann Neurol 43: 465-471 .

Genain CP et al. (1999) Identification of autoantibodies associated with myelin damage in multiple sclerosis . Nature Med 5: 170-175 .

Lucchinetti C et al. (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination . Ann Neurol 47: 707-717 .

10.

Reindl M et al. (1999) Antibodies against the myelin oligodendrocyte glycoprotein and the myelin basic protein in multiple sclerosis and other neurological diseases: a comparative study . Brain 122: 2047-2056 .

11.

Weinshenker BG et al. (1999) A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease . Ann Neurol 46: 878-886 .

12.

Brück W et al. (1997) Inflammatory central nervous system demyelination: correlation of magnetic resonance imaging findings with lesion pathology . Ann Neurol 42: 783-793 .

13.

Poser CM et al. (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol 13: 227-231 .

14.

Lassmann H et al. (1998) Immunopathology of multiple sclerosis: report on an international meeting held at the Institute of Neurology of the University of Vienna . J Neuroimmunol 86: 213-217 .

15.

Brück W et al. (1995) Monocyte/macrophage differentiation in early multiple sclerosis lesions . Ann Neurol 38: 788-796 .

16.

Breitschopf H et al. (1992) In situ hybridization with digoxigenin-labeled probes: sensitive and reliable detection method applied to myelinating rat brain . Acta Neuropathol 84: 581-587 .

17.

Bogumil T et al. (1998) Serum levels of macrophage-derived protein MRP8/14 are elevated in active multiple sclerosis . Neurosci Lett 247: 195-197 .

18.

Gay D , Esiri M. (1991) Blood-brain barrier damage in acute multiple sclerosis plaques. An immunocytological study . Brain 114: 557-572 .

19.

Aarli JA et al. (1975) Binding of normal human IgG to myelin sheaths, glia and neurons . Immunology 28: 171-185 .

20.

Vanguri P , Shin ML. (1986) Activation of complement by myelin: identification of C1-binding proteins of human myelin from central nervous tissue . J Neurochem 46: 1535-1541 .

21.

Karni A et al. (1999) Elevated levels of antibody to myelin oligodendrocyte glycoprotein is not specific for patients with multiple sclerosis . Arch Neurol 56: 311-315 .

22.

Clanet M , Berry I. (1998) Magnetic resonance imaging in multiple sclerosis . Curr Opin Neurol 11: 299-303 .

23.

Fazekas F et al. (1999) The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis . Neurology 53: 448-456 .

24.

Powell T , Sussman JG , Davies-Jones GAB. (1992) MR imaging in acute multiple sclerosis: ringlike appearance in plaques suggesting the presence of paramagnetic free radicals . AJNR Am J Neuroradiol 13: 1544-1546 .

25.

Masdeu JC et al. (2000) Open-ring imaging sign. Highly specific for atypical brain demyelination . Neurology 54: 1427-1433 .

26.

Rodriguez M et al. (1993) Plasmapheresis in acute episodes of fulminant CNS inflammatory demyelination . Neurology 43: 1100-1104 .

27.

Radzun HJ et al. (1991) Detection of a monocyte/macrophage differentiation antigen in routinely processed paraffin-embedded tissues by monoclonal antibody Ki-M1P . Lab Invest 65: 306-315 .

28.

Piddlesden SJ et al. (1993) The demyelinating potential of antibodies to myelin oligodendrocyte glycoprotein is related to their ability to fix complement . Am J Pathol 143: 555-564 .

Clinical,radiological,immunological and pathological findings in inflammatory CNS demyelination-possible markers for an antibody-mediated process

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