Differential Diagnosis of Suspected Multiple Sclerosis in Pediatric and Late-Onset Populations: A Review.

IF 20.4 1区医学 Q1 CLINICAL NEUROLOGY

JAMA neurology Pub Date : 2024-09-16 DOI:10.1001/jamaneurol.2024.3062

Le H Hua, Andrew J Solomon, Silvia Tenembaum, Antonio Scalfari, Àlex Rovira, Kevin Rostasy, Scott D Newsome, Ruth Ann Marrie, Melinda Magyari, Orhun Kantarci, Bernhard Hemmer, Cheryl Hemingway, Mary Pat Harnegie, Jennifer S Graves, Jeffrey A Cohen, Riley Bove, Brenda Banwell, John R Corboy, Emmanuelle Waubant

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引用次数: 0

Abstract

Importance: While the typical onset of multiple sclerosis (MS) occurs in early adulthood, 2% to 10% of cases initially present prior to age 18 years, and approximately 5% after age 50 years. Guidance on approaches to differential diagnosis in suspected MS specific to these 2 age groups is needed.

Observations: There are unique biological factors in children younger than 18 years and in adults older than age 50 years compared to typical adult-onset MS. These biological differences, particularly immunological and hormonal, may influence the clinical presentation of MS, resilience to neuronal injury, and differential diagnosis. While mimics of MS at the typical age at onset have been described, a comprehensive approach focused on the younger and older ends of the age spectrum has not been previously published.

Conclusions and relevance: An international committee of MS experts in pediatric and adult MS was formed to provide consensus guidance on diagnostic approaches and key clinical and paraclinical red flags for non-MS diagnosis in children and older adults.

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儿童和晚发人群疑似多发性硬化症的鉴别诊断：综述。

重要性：多发性硬化症（MS）通常在成年早期发病，但也有 2% 至 10% 的病例在 18 岁之前发病，约 5% 的病例在 50 岁之后发病。我们需要针对这两个年龄段的疑似多发性硬化症患者的鉴别诊断方法提供指导：与典型的成人多发性硬化症相比，18 岁以下的儿童和 50 岁以上的成人有其独特的生物因素。这些生理差异，尤其是免疫和激素差异，可能会影响多发性硬化症的临床表现、对神经元损伤的恢复能力以及鉴别诊断。虽然已经描述了典型发病年龄段多发性硬化症的模拟病例，但之前尚未发表过侧重于年龄谱的年轻和年长两端的综合方法：由儿童和成人多发性硬化症专家组成的国际委员会就诊断方法以及儿童和老年人非多发性硬化症诊断的关键临床和准临床信号提供了共识指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JAMA neurology CLINICAL NEUROLOGY-

CiteScore

41.90

自引率

1.70%

发文量

250

期刊介绍： JAMA Neurology is an international peer-reviewed journal for physicians caring for people with neurologic disorders and those interested in the structure and function of the normal and diseased nervous system. The Archives of Neurology & Psychiatry began publication in 1919 and, in 1959, became 2 separate journals: Archives of Neurology and Archives of General Psychiatry. In 2013, their names changed to JAMA Neurology and JAMA Psychiatry, respectively. JAMA Neurology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications.