IngentaConnect Stroke after initiation of interferon-beta treatment for relapsin...

Authors: Bosche, B.; Dohmen, C.¹; Impekoven, P.²; Weber, O. Z.¹; Reske, D.¹; Rubbert, A.³; Jacobs, A. H.¹; Petereit, H.-F.¹

Source: Acta Neurologica Scandinavica, Volume 113, Number 6, June 2006 , pp. 433-436(4)

Publisher: Blackwell Publishing

Abstract:

Bosche B, Dohmen C, Impekoven P, Weber OZ, Reske D, Rubbert A, Jacobs AH, Petereit H-F. Stroke after initiation of interferon beta treatment for relapsing–remitting disseminated white matter disease.

Acta Neurol Scand 2006: 113: 433–436.

Interferon-beta (INF-β) is effective and used in reducing exacerbation frequency and disease progression in multiple sclerosis. In certain circumstances, INF-β can lead to rare side effects. Aims of the study –

We report the case of a 34-year-old female patient satisfying the McDonald criteria of multiple sclerosis without showing typical pathologic changes in cerebrospinal fluid (CSF). After introduction of INF-β treatment, she quickly developed further progression of her disseminated neurological symptoms and finally an ischemic cerebral infarction. Methods –

Evaluation of the patient included arterial angiography, magnetic resonance and positron emission tomography, histopathological assessment as well as a broad spectrum of serum and CSF analysis. Results –

All diagnostic evaluations and the clinical course revealed evidences for a primary angiitis of the CNS. We discuss the possible worsening due to inappropriate INF-β treatment in cerebral angiitis promoting severe cerebrovascular insufficiency. Conclusion –

The authors suggest that all diagnostic multiple sclerosis criteria including typical CSF findings should be ascertained before INF-β treatment is initiated.

Keywords: relapsing-remitting white matter disease; multiple sclerosis revised diagnostic criteria; interferon-beta; primary angiitis of the CNS; endothelium; ischemic infarction

Document Type: Research article

DOI: 10.1111/j.1600-0404.2006.00638.x

Affiliations: 1: Department of Neurology, University of Cologne, Germany 2: Department of Neuroradiology, University of Cologne, Germany 3: Department of Internal Medicine, University of Cologne, Germany

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Stroke after initiation of interferon-beta treatment for relapsing–remitting disseminated white matter disease