Suchergebnisse

Abstract
Autoantibodies most commonly found in association with neuropathies are those against the ganglioside family antigens - GM1, GQ1b, asialo-GM1, GM2, GD1a, and GD1b. The major diagnostic role is set for two of antibodies - anti-GM1 and anti-GQ1b. This retrospective study was designed to evaluate the status of antiganglioside antibodies in patients with possible autoimmune neuropathy. The study included 85 patients tested for antiganglioside antibodies during their hospitalization. Clinical information such as demographic data and antecedent illness was collected for all patients, and paraclinical studies including results from cerebrospinal fluid and neuroelectrophysiological examination were analyzed. In our study, a total of 27 patients (32%) were found positive for at least one antiganglioside antibody. The most commonly found antibodies were against asialoGM1 (n=13) and GM1 (n=10) gangliosides. Eight patients were diagnosed with a disease where antiganglioside antibodies are used as a diagnostic marker: five patients - Guillain-Barré syndrome (GBS), 1 patient - Miller-Fisher syndrome (MFS), two patients - multifocal motor neuropathy (MMN). Three out of five patients diagnosed with GBS and one of two patients diagnosed with MMN were seronegative. The acute course of disease, positive antiganglioside antibodies and cytoalbuminologic dissociation in cerebrospinal fluid-induced patients is preference for a specific immune therapy. The results of our study support the previously described immunological association between antiganglioside antibodies and GBS, MFS, and MMN.

Abstract
Therapeutic plasma exchange (TPE) is used in many neurological disorders to remove immunoglobulin and other immunologically active substances. We observed patients that were admitted in Rīga East Clinical University Hospital "Gaiļezers", Clinic of Neurology and Neurosurgery, Multiple Sclerosis Unit, and were diagnosed with relapsing remitting multiple sclerosis (MS), according to McDonald criteria 2010 (five patients), Neuromyelitis optica (NMO) spectrum disorders (three patients) and one with NMO, according to Wingerchuk 2006 criteria. All relapses were confirmed according to clinical criteria. Visual acuity was assessed by an ophthalmologist, and neurological status by a neurologist. All patients received at least 1 cycle of 1000 mg methylprednisolone intravenous for five to seven days. The expanded disability status scale score in the MS patient group was in range 4.0-9.0 before TPE and 3.5-6.5 range after TPE. Best improvement was observed in the MS group: mean symptom reduction of 20%. Patients with NMO spectrum disorder had an EDSS score of 8.0-8.5 range on admission and 6.5-8.0 range after TPE. After one month, one patient in the NMO spectrum disorder group had good response to TPE and EDSS was 3.5, two patients had only slight improvement (EDSS scores 8.0 and 7.5). Condition of patients with NMO did not improve even after a month.

Cytomegalovirus chronic infection as a risk factor for stroke: a prospective study
Stroke is the second most common cause of death in the world and a major cause of long-term disability. Chronic infection is an independent risk factor for ischemic stroke and related forms of atherosclerotic vascular disease. The aim of our study was to compare the plasma Cytomegalovirus (CMV) immunoglobulin G antibody level in a patient and control group, and to determine the association of CMV chronic infection with ischemic stroke, and with stroke subtype. The present study does not present a cogent demonstration that cytomegalovirus chronic infection is a risk factor of stroke. Further studies are necessary to clarify the effective prophylactic measures to determine other significant risk factors for stroke.

Abstract
Myasthenia gravis (MG) is an autoimmune disease characterized by autoantibody mediated postsynaptic failure of neuromuscular transmission. The thymus gland has a role in the pathogenesis of MG. The aim of this study was to determine (1) the prevalence of different thymic pathologies in the MG patient population of Latvia; (2) the potential impact of different thymus pathologies on the clinical course of MG; and (3) the effectiveness of surgical treatment of thymic pathologies in Latvia. The results showed that the most common thymus pathology among the patients with MG in Latvia is thymoma. Compared to the published data, the proportion of MG patients diagnosed with thymus hyperplasia in Latvia is very small. Thymus hyperplasia is uncommon among patients 60 years of age and older. MG onset for patients with thymoma is significantly later than that of patients with thymus hyperplasia. Almost all patients with thymoma or thymus hyperplasia develop a generalised form of MG. The presence of a thymus pathology does not significantly affect the electrophysiological test results, clinical symptom severity, frequency of disability or hospitalisation of the patients with MG. Thymectomy in patients with thymoma or thymus hyperplasia has no significant effect on relieving MG symptoms