Diagnóstico de Esclerose Múltipla em Adolescentes Segundo os Critérios de McDonald de 2017: Dois Casos Clínicos

Autores

  • Daniela Araújo Serviço de Pediatria, Hospital de Braga, Braga, Portugal https://orcid.org/0000-0001-9683-7478
  • Ângela Pereira Serviço de Pediatria, Hospital de Braga, Braga, Portugal
  • Sofia A. Martins Consulta de Neuroimunologia, Serviço de Neurologia, Hospital de Braga, Braga, Portugal https://orcid.org/0000-0003-3197-1320
  • Ricardo Maré Consulta de Neuroimunologia, Serviço de Neurologia, Hospital de Braga, Braga, Portugal
  • João Cerqueira Consulta de Neuroimunologia, Serviço de Neurologia, Hospital de Braga, Braga, Portugal https://orcid.org/0000-0003-3155-2775
  • Susana Carvalho Serviço de Pediatria, Hospital de Braga, Braga, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/210059/2022

Palavras-chave:

Adolescente, Esclerose Múltipla/diagnóstico, Esclerose Múltipla/diagnóstico por imagem

Resumo

Although multiple sclerosis’ (MS) diagnosis is usually made in adulthood, clinical presentation before the age of 18 occurs in up to 10% of the individuals. McDonald’s criteria applicability in diagnosing MS in adolescents is already established with the 2010 revision. The first clinical case we present is an adolescent with a family history of MS and a right retrobulbar optic neuritis’ presentation. Magnetic resonance imaging revealed periventricular and infratentorial lesions white matter lesions. The second case describes an adolescent with a suggestive presentation of acute transverse myelitis, with a sensitive level in D10 and multiple brain and spinal inflammatory lesions. Cerebrospinal fluid oligoclonal bands were present in both patients. Both met the 2017 McDonald criteria for MS diagnosis. MS diagnosis is particularly difficult in children and adolescents. A high degree of suspicion is needed. Differential diagnosis with other cerebral inflammatory disorders must be considered.

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Referências

Alroughani R, Boyko A. Pediatric Multiple Sclerosis: A Review. BMC Neurol. 2018;18:27. doi:10.1016/j. yapd.2019.03.003

Chou IJ, Wang HS, Whitehouse WP, Constantinescu CS. Paediatric Multiple Sclerosis: Update on Diagnostic Criteria, Imaging, Histopathology and Treatment Choices. Curr Neurol Neurosci Rep. 2016;16. doi:10.1007/s11910-016-0663-4

Sandvig I, Barlinn J, Nedregaard B, Skjeldal OH. Multiple sclerosis in children and adolescents. An important differential diagnosis of acute neurological disease. Eur J Paediatr Neurol. 2015;19:211–217. doi:10.1016/j.ejpn.2014.12.004

Correia AS, Augusto L, Meireles J, Pinto J, Sousa AP. Pediatric Multiple Sclerosis in Portugal: A Multicentre Study. Acta Med Port. 2016;29:425. doi:10.20344/amp.6346

Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Ann Neurol. 2011;69:292–302. doi:10.1002/ana.22366

Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162– 73. doi:10.1016/S1474-4422(17)30470-2

Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, Seze J de, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85:177–89. doi:10.1212/ WNL.0000000000001729

Galardi MM, Gaudioso C, Ahmadi S, Evans E, Gilbert L, Mar S. Differential Diagnosis of Pediatric Multiple Sclerosis. Children. 2019;6:75. doi:10.3390/children6060075

Makhani N, Tremlett H. The multiple sclerosis prodrome. Nat Revi Neurol; 21: 515-21. doi:10.1038/s41582-021-00519-3

Forslin Y, Granberg T, Jumah AA, Aspelin P, Kristoffersen-Wiberg M, Martolaet J, et al. Incidence of radiologically isolated syndrome: A population-based study. Am J Neuroradiol. 2016;37:1017–22. doi:10.3174/ajnr.A466010.

Okuda DT, Siva A, Kantarci O, Inglese M, Katz I, Tutuncu M, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9:e90509. doi:10.1371/journal.pone.0090509.

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Publicado

2024-04-20

Como Citar

1.
Araújo D, Pereira Ângela, A. Martins S, Maré R, Cerqueira J, Carvalho S. Diagnóstico de Esclerose Múltipla em Adolescentes Segundo os Critérios de McDonald de 2017: Dois Casos Clínicos. Sinapse [Internet]. 20 de Abril de 2024 [citado 21 de Dezembro de 2024];22(3):120-6. Disponível em: https://sinapse.pt/index.php/journal/article/view/59

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