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被误诊为多发性硬化症的遗传疾病:观察性研究和文献综述
Daniele Mandia1, Natalia Shor2, Alise K Carlson3
1Department of Neurology, Neurometabolism Unit, Reference Center for Metabolic and Lysosomal Neurological Diseases, Hôpital Pitié-Salpêtrière, Paris, France.
Multiple sclerosis and related disorders
|May 30, 2025
概括
成人发病的神经遗传疾病经常被误诊为多发性硬化症 (MS). 识别非典型的MRI特征和整合遗传评估可以改善CADASIL等疾病的诊断,防止不必要的MS治疗.
科学领域:
- 神经遗传学 神经遗传学
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 患有白质异常的成年神经遗传疾病 (NGD) 是罕见的,由于临床和放射性特征的重叠,经常被误诊为多发性硬化症 (MS).
- 错误诊断可能导致不必要的免疫抑制治疗和延迟的遗传咨询.
研究的目的:
- 评估NGD被误诊为MS (Mis-MS) 或同时存在MS (NGD-MS) 的患者的特征.
- 为了提高成年期NGD模仿MS的诊断准确度.
主要方法:
- 在七个欧洲和北美多发性硬化中心对46名患者进行了回顾性多中心分析.
- 对模仿MS的NGD系统性文献综述.
- 对临床,放射学 (MRI) 和遗传数据的分析.
主要成果:
- 误诊为MS的常见NGD包括CADASIL (22%),ALSP (8%) 和AOAD (5%).
- NGD的中位诊断延迟时间为9年.
- 80%的Mis-MS患者具有非典型的MRI特征,但41%符合MS传播标准;92%缺乏CSF寡克隆带.
结论:
- 由于重叠的特征,模仿MS的NGD的诊断具有挑战性.
- 卡达西尔,ALSP和AOAD经常被误诊为MS.
- 识别非典型的MRI模式和整合临床/遗传评估可以提高诊断准确性和患者护理.
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