Multiple sclerosis-like manifestations in systemic autoimmune and inflammatory disorders: an update

Area of Science:

• Neuroimmunology
• Neurology
• Demyelinating Diseases

Background:

• Multiple sclerosis (MS) is a central nervous system (CNS) autoimmune demyelinating disease.
• MS diagnosis can be challenging due to clinical overlap with systemic autoimmune diseases (SADs).
• SADs with CNS involvement can mimic MS symptoms like transverse myelitis and optic neuritis, leading to misdiagnosis.

Purpose of the Study:

• To review the physiology of CNS myelin.
• To discuss the pathophysiology of MS and MS-mimicking immune-mediated demyelinating diseases.
• To highlight diagnostic challenges and treatment strategies for MS and similar conditions.

Main Methods:

• Literature review focusing on MS pathophysiology and differential diagnoses.
• Analysis of clinical presentations of MS and MS-mimicking conditions.
• Discussion of diagnostic criteria and treatment approaches.

Main Results:

• Systemic autoimmune diseases (SADs) are significant mimics of MS.
• Diagnostic uncertainty in early neurological episodes is common.
• Misdiagnosis can lead to improper treatment and increased disability.

Conclusions:

• Careful clinical evaluation, imaging, and exclusion of alternative diagnoses are vital.
• Understanding subtle distinctions between MS and SADs is crucial for accurate diagnosis.
• Prompt and correct diagnosis improves patient outcomes and reduces disability.