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Multiple sclerosis and amyloid deposits in the white matter of the brain
I Nennesmo1, N Bogdanovic, A L Petrén
1Division of Pathology, Karolinska Institute, Huddinge Hospital, Sweden. inne@patd01.hs.sll.se
Abstract:
We present the neuropathological findings in a female patient with clinically definite multiple sclerosis (MS), who at autopsy had multifocal amyloid deposits in the white matter of the brain without other signs of amyloidosis. The patient had relapsing/remitting MS between the ages of 26 and 45, and during her last 14 years she had a secondary chronic progressive form of MS. Previous reports of amyloid deposits in MS are reviewed and the possible relationship between amyloid deposits and the increased production of immunoglobulin free light chains in MS is discussed.
Insights
Neuropathology revealed multifocal amyloid deposits in the brain white matter of a multiple sclerosis (MS) patient. This finding, unusual in MS, may relate to increased immunoglobulin free light chains.
Area of Science:
- Neuropathology
- Neuroimmunology
- Amyloidosis
Background:
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- Amyloid deposition is not a typical feature of multiple sclerosis.
- Previous studies have occasionally reported amyloid in MS, but its significance remains unclear.
Observation:
- This study details the neuropathological findings in a female patient with a long history of clinically definite multiple sclerosis.
- The autopsy revealed multifocal amyloid deposits specifically within the white matter of the brain.
- Crucially, the patient exhibited no other systemic signs of amyloidosis.
Findings:
- The patient experienced relapsing-remitting MS from age 26 to 45, transitioning to a secondary chronic progressive form for the last 14 years.
- The presence of amyloid deposits in the brain white matter was a distinct neuropathological finding.
- No evidence of generalized amyloidosis was observed, localizing the deposits to the central nervous system.
Implications:
- The findings prompt a re-evaluation of the potential role of amyloid deposits in the pathogenesis of multiple sclerosis.
- A possible link between these amyloid deposits and the elevated production of immunoglobulin free light chains, often seen in MS, is discussed.
- Further research is warranted to elucidate the relationship between amyloidosis and immunoglobulin abnormalities in MS progression.