THE PROGNOSTIC AND IMMUNOGENETIC FEATURES OF OPTIC NEURITIS IN THE CHILDREN PRESENTING WITH DISSEMINATED SCLEROSIS


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Abstract

The present work was designed to estimate the prognostic value of clinical features of optic neuritis based on the study of 67 patients (38 girls and 29 boys) at the age under 16 years presenting with the confirmed diagnosis of disseminated sclerosis in the beginning of the demyelinizing disease. The prognostic significance of optic neuritis as the earliest manifestation of disseminated sclerosis was evaluated by comparing clinical symptoms in the patients of this group with those in the children with a different onset of disseminated sclerosis. The clinical assessment of the neurologic status was done based on the Kutrzke expanded disability status scale. Subject to the prognostic analysis were the age of the patients at the onset of the disease and its clinical features, the annual frequency of exacerbations, the time of secondary progress, and formation of neurological deficit. The following procedures were performed: fundus examination, computed perimetry, electrophysiological and immunogenetic studies, the latter being focused on genotyping HLA class II region of chromosome 6. It was shown that optic neuritis is a common manifestation of disseminated sclerosis in the children. The severity of sclerosis decreases when the myelinizing disease starts as optic neuritis rather than otherwise. The clinical features of optic neuritis are virtually identical when it is the first manifestation of optic neuritis and in the case of exacerbation of the primary disease. On the whole, the children suffering disseminated sclerosis were shown to exhibit the enhanced occurrence of DR2(15) haplotype especially when this condition initially developes as optic neuritis.

About the authors

M. R Guseva

Российский государственный национальный исследовательский медицинский университет им. Н. И. Пирогова Минздравсоцразвития России

д-р мед. наук, проф. каф. офтальмологии педиатрического ф-та

S. Yu Boiko

Российский государственный национальный исследовательский медицинский университет им. Н. И. Пирогова Минздравсоцразвития России

д-р мед. наук, проф. каф. неврологии и нейрохирургии лечебного ф-та

A. N Boiko

Российский государственный национальный исследовательский медицинский университет им. Н. И. Пирогова Минздравсоцразвития России

д-р мед. наук, проф. каф. неврологии и нейрохирургии лечебного ф-та

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