pop quiz re actual 2018 study: Pure spinal MS

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pop quiz re actual 2018 study: Pure spinal MS

Postby jimmylegs » Wed Aug 29, 2018 2:29 pm

pop quiz: name one key differential dx for 'pure spinal multiple sclerosis'

Pure spinal multiple sclerosis: A possible novel entity within the multiple sclerosis disease spectrum (2018)
http://journals.sagepub.com/doi/abs/10. ... 8518775912
Abstract
We identified five female patients retrospectively with relapsing short-segment partial myelitis whose clinical and paraclinical features were suggestive of cord involvement of multiple sclerosis (MS)-type albeit not rigidly fulfilling the 2017 McDonald criteria. Notably, these patients had not developed any typical MS-like brain lesions despite repeated neuroimaging assessments over years. Comprehensive work-up for differential diagnoses of MS and other causes of transverse myelitis particularly neuromyelitis optica spectrum disorders had been consistently negative on longitudinal follow-up. Thus, we postulate a possible entity of pure spinal MS which may represent a novel forme fruste within the MS disease spectrum.

lots of different tests shown in the various tables and figures of the full text.

one guess which test is missing from the array.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: pop quiz re actual 2018 study: Pure spinal MS

Postby frodo » Fri Aug 31, 2018 12:08 am

This looks quite similar to the new described "myelocortical MS" (MCMS):

"However, in the new findings, a research team led by Bruce Trapp, Ph.D., identified for the first time a subtype of the disease that features neuronal loss but no demyelination of the brain’s white matter"

https://reliawire.com/myelocortical-ms/
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Re: pop quiz re actual 2018 study: Pure spinal MS

Postby jimmylegs » Fri Aug 31, 2018 11:22 am

interesting.

re the pop quiz, the missing test is serum cobalamin

b12: there to be ruled out:

Differential diagnosis of suspected multiple sclerosis: a consensus approach
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850590/
Hematological manifestations - Thrombotic thrombocytopenic purpura; vitamin B12 deficiency; Wilson's disease (hemolytic anemia); copper deficiency

related

VITAMIN, MINERAL & NUTRITION RELATED SYNDROMES
https://neuromuscular.wustl.edu/nother/vitamin.htm#B12

Vitamin B12 (Cobalamin) deficiency
-Pathology
--Spinal cord

----Multifocal axonal loss & demyelination
----Localization
------Cervical & thoracic

------Posterior column > Anterolateral & Anterior
---------Peripheral nerve: Axonal loss; Occasional ± demyelination

Vitamin B12 deficiency. Prevalence among South Asians at a Toronto clinic (2004)
http://www.cfp.ca/content/50/5/743.short
RESULTS B12 results were documented in 49% of charts; 46% of results showed deficiency. Patients older than 65 and vegetarians were more likely to be B12 deficient. Low serum B12 levels were positively correlated with low hemoglobin and ferritin levels and poorly correlated with low MCV levels.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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jimmylegs
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Posts: 11555
Joined: Sat Mar 11, 2006 4:00 pm


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