Neprepoznati poremećaj spektra optičkog neuromijelitisa sa mikrokrvarenjem u ponsu i corpus-u callosum-u

English

  • Igor Nosek Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia
  • Jasmina Boban Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia
  • Dmitar Vlahović University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia
  • Biljana Radovanović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Dejan Kostić Military Medical Academy, Department of Computerized Tomography and Magnetic Resonance, Belgrade, Serbia
  • Duško Kozić Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia
DOI: https://doi.org/10.2298/VSP201126086N
Ključne reči: anti-akvaporin 4 autoantitela, magnetna rezonanca, snimanje, bolesti, neuroinflamatorne, neuromijelitis optika, lečenje, ishod

Sažetak


 

Uvod. Neuromijelitis optika – spektar poremećaja (NMOSP) predstavlja neuroinflamatorni sindrom, posredovan imunskim mehanizmima, klasifikovan kao poseban entitet nakon otkrića akvaporin-4 imunoglobulina klase G (anti-AQP4-IgG). Spektar nalaza NMOSP na snimcima magnetne resonance klasično uključuje bilateralni optički neuritis i longitudinalno ekstenzivni transverzalni mijelitis (LETM), a odskora je proširen lezijama u area postrema, dijencefalonu, moždanom stablu i cerebelumu, i ekstenzivnom atrofijom kičmene moždine. Prikaz bolesnika. Prikazana je bolesnica sa prisutnim anti-AQP4 autoantitelima, starosti 65 godina, sa inicijalnom, potcenjenom, prezentacijom LETM koja je razvila multiple cerebralne i cerebelarne litičke demijelinizacione lezije povezane sa akutnim neuritisom dugog segmenta optičkog nerva dve godine kasnije. Dva nova nalaza na snimcima opisana su kao zahvatanje kompletne transverzalne površine ponsa i mikrokrvarenja u ponsu i corpus-u callosum-u. Zaključak. Sumnja na NMOSP je od velikog značaja kod bolesnika sa izolovanim LETM da bi se sprečili relapsi u anti-AQP4-IgG pozitivnim slučajevima i poboljšala prognoza i oporavak.

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Objavljeno
2023/01/04
Broj časopisa
Vol. 79 Br. 12 (2022): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika