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Published on: July 4, 2007

A case of exacerbated multiphasic disseminated encephalomyelitis after interferon β treatment

Suqin Chen1, Aimin Wu, Bingjun Zhang

  • 1Multiple Sclerosis Centre, Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, China.

Journal of the Neurological Sciences
|January 15, 2013
PubMed

Insights

Multiphasic disseminated encephalomyelitis (MDEM) can worsen with interferon beta (IFN-β) treatment, a condition mimicking multiple sclerosis (MS). Caution is advised when using IFN-β in MDEM patients due to potential disease exacerbation.

Area of Science:

  • Neuroimmunology
  • Central Nervous System (CNS) Disorders
  • Inflammatory Demyelinating Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an inflammatory CNS demyelinating disorder, potentially monophasic or relapsing.
  • Relapsing ADEM can be misdiagnosed as multiple sclerosis (MS), complicating diagnosis and treatment.
  • Multiphasic disseminated encephalomyelitis (MDEM) represents a relapsing form of ADEM.

Observation:

  • A 16-year-old female initially diagnosed with ADEM experienced two relapses over 28 months.
  • Misdiagnosed with MS, she was treated with interferon beta (IFN-β).
  • A severe relapse occurred 5 months post-IFN-β initiation, fulfilling MDEM criteria.

Findings:

  • Interferon beta (IFN-β) treatment exacerbated the patient's MDEM.
  • The severe relapse presented with significant clinical and MRI worsening.
  • Halting IFN-β treatment led to disease stabilization with no new relapses.

Implications:

  • IFN-β treatment may worsen MDEM, similar to its effects in neuromyelitis optica.
  • Clinical vigilance is crucial when considering IFN-β for patients with suspected or confirmed MDEM.
  • This case highlights the importance of accurate diagnosis to guide appropriate therapeutic strategies in demyelinating CNS disorders.

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