medigraphic.com

2014, Number 6

<< Back Next >>

Rev Fac Med UNAM 2014; 57 (6)

Multiple sclerosis: neurological disease with high social impact. Back to the old treatment

Guadarrama-Ortiz P, Regalado GX, Castillo-Rangel C, Ángeles-Castellanos M

Language: Spanish
References: 21
Page: 5-10
PDF size: 348.44 Kb.


ABSTRACT

Multiple sclerosis (MS) is a chronic inflammatory and immune- degenerative disease that affects young people and has a high social impact due to direct and indirect costs.
Objective: Regulate neurodegenerative process through a suitable modulation of inflammatory factors by using methylprednisolone and evaluation with Magnetic Resonance studies.
Patients and methods: Female patients between the 1st and 5th decade of life, with diagnosis of Multiple Sclerosis, were included in the study if they met the criteria of McDonal 2010 (specially space and time monitoring) methylprednisolone boluses were administered regularly, even when the patient had no relapses, and the patients were then evaluated with Magnetic Resonance per annum, with a follow-up of up to 15 years.
Results: There is a marked decrease of lesion in function of time and the bolus administration of methylprednisolone, and lesions disappeared entirely after 3 to 10 years of administration.
Conclusions: The regular bolus administration of methylprednisolone attenuates the inflammatory process and the damage to the blood brain barrier and thus contributes in preventing neurodegeneration and is coadyuvant in remyelination.


REFERENCES

  1. Corona T, Román GC. Multiple Sclerosis in Latin America. Neuroepidemiology. 2006;26:1-3.

  2. Tsang BK, Macdonell R. Multiple sclerosis, Diagnosis, management and prognosis. Aust Fam Physician: 40;12:948-55.

  3. Rivera VM. Esclerosis múltiple en Latinoamérica. Rev Espa- ñola de Esclerosis Múltiple. 2008;9:17-23.

  4. Compston A. McAlpine’s multiple sclerosis. Philadelphia: Elsevier/Churchill Livingstone, 2006.

  5. Sadovnick AD, Ebers GC, Wilson RW, Paty DW. Life expectancy in patients attending multiple sclerosis clinics. Neurology. 1992;42:991-4.

  6. Bronnum-Hansen H, Koch-Henriksen N, Stenager E. Trends in survival and cause of death in Danish patients with multiple sclerosis. Brain 2004;127:844-50.

  7. Corona-Vázquez T, Flores-Rivera JJ. Esclerosis múltiple. Epidemiología. Ed Med Panam. 2010:7-25.

  8. Finlayson M, Cho CA. A descriptive profile of caregivers of older adults with MS and the assistance they provide. Disability and Rehabilitation. 2008;30(24):1848-57.

  9. Kobelt G, Berg J, Atherly D, Hadjimichael O. Costs and quality of life in multiple sclerosis: a cross-sectional study in the United States. Neurology. 2006;66:1696-702.

  10. Miljković Z, Momčilović M, Miljkovic D, Mostarica-Stojković M. Methylprednisolone inhibits IFN-γ and IL-17 expression and production by cells infiltrating central nervous system in experimental autoimmune encephalomyelitis. Journal of Neuroinflammation. 2009;6:37. Disponible en: http://www.jneuroinflammation.com/content/6/1/37/

  11. Rudick R, Bruce D. Gray-Metter Injury in Multiple Sclerosis. N Engl J Med. 2009;361(15):1505-6.

  12. Pelletier D, Hafler DA. Fingolimod for Multiple Sclerosis. New England Journal of Medicine. 2012;366:339-47.

  13. Then-Bergh F, Kümpfel T, Schumann E, Held U, Schwan M, Blazevic M, et al. Monthly intravenous methylprednisolone in relapsing-remitting multiple sclerosis - reduction of enhancing lesions, T2 lesion volume and plasma prolactin concentrations. BMC Neurology. 2006;9:19.

  14. Lyons PR, Newman PK, Saunders M. Methylprednisolone therapy in multiple sclerosis: a profile of adverse effects. Journal of Neurology, Neurosurgery, and Psychiatry. 1988; 51:285-7.

  15. Takahashi A, Kanno Y, Takahashi Y, Sakamoto N, Monoe K, Saito H, et al. Development of autoimmune hepatitis type 1 after pulsed methylprednisolone therapy for multiple sclerosis: A case report. World J Gastroenterol. 2008;14(35):5474-7.

  16. Castillo M. Transtornos de la sustancia blanca. En: Neurorradiología. Ed. Journal. 2004. pp 70-74.

  17. Yousry TA, Filippi M, Becker C, et al. Comparison of MR pulse sequences in the detección of multiple sclerosis lesions. AJNR Am J Neuroradiol. 1997;18:959-63.

  18. Horowitz AL, Kaplan RD, Grewe G y cols. The ovoid lesion: a new MR observation in patients with multiple sclerosis. AJNR Am J Neuroradiol 1989;10:303-305.

  19. Alam SM, Kyriakides T, Lawden M, Newman PK. Methylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy al equivalent high dose. Journal of Neurology, Neurosurgery and Psychiatry. 1993; 56:1219-20.

  20. Elliott C, Lindner M, Arthur A, et al. Functional identification of pathogenic autoantibody responses in patients with multiple sclerosis. Brain. 2012:135;1819-33.

  21. Katzman GL. Multiple Sclerosis. En: Osborn AG, Blaser SI, Salzman KL, Katzman GL, Provenzale J, Castillo M, et al. Diagnostic Imaging, Brain. Salt Lake City, Utah: Amyrsis, 2004. I-8. pp. 74.




2020     |     www.medigraphic.com