A Case of Childhood Relapsing.remitting Multiple Sclerosis Treated with Interferon Beta
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Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system that is primarily a disease of young adulthood. Onset before 10 years of age is considered unusual. We report a boy with MS with onset at 34 months of age who was effectively treated with interferon beta 1b. He visited the emergency room with seizure, left-side limb weakness, and intentional tremor on the left hand. He had received influenza (H1N1) vaccination 1 week prior to that event. Brain magnetic resonance imaging (MRI) disclosed multifocal edematous T2-weighted hyper- intensity lesions in the left thalamus, bilateral midbrain, pons, medulla, cerebral cortices, and subcortical white matter. This presentation suggested the diagnosis of ADEM. Intravenous methylprednisolone was administered and the symptoms recovered completely. Fifteen months later, he experienced gait disturbance, intentional tremor, and dysarthria and a new T2-weighted hyperintensity lesion was found on brain MRI. The diagnosis of early-onset MS was made and the patient was administered interferon beta-1b every other day. He was relapse free after the treatment. However, he experienced flu-like symptoms and intermittent fever and temporary withdrawal of interferon beta-1b led to relapse of MS. Intravenous methylprednisolone was administered again and his symptoms improved gradually. Currently, at 5 years of age, he has been relapse free from 3 months after interferon beta-1b was administered consistently. This case showed that interferon beta had positive effects to reduce relapses in pediatric MS patients, and pediatric MS relapsed during withdrawal of interferon beta for a short period.
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system that is primarily a disease of young adulthood. Onset before 10 years of age is considered unusual. We report a boy with MS with onset at 34 months of age who was effectively treated with interferon beta 1b. He visited the emergency room with seizure, left-side limb weakness, and intentional tremor on the left hand. He had received influenza (H1N1) vaccination 1 week prior to that event. Brain magnetic resonance imaging (MRI) disclosed multifocal edematous T2-weighted hyper- intensity lesions in the left thalamus, bilateral midbrain, pons, medulla, cerebral cortices, and subcortical white matter. This presentation suggested the diagnosis of ADEM. Intravenous methylprednisolone was administered and the symptoms recovered completely. Fifteen months later, he experienced gait disturbance, intentional tremor, and dysarthria and a new T2-weighted hyperintensity lesion was found on brain MRI. The diagnosis of early-onset MS was made and the patient was administered interferon beta-1b every other day. He was relapse free after the treatment. However, he experienced flu-like symptoms and intermittent fever and temporary withdrawal of interferon beta-1b led to relapse of MS. Intravenous methylprednisolone was administered again and his symptoms improved gradually. Currently, at 5 years of age, he has been relapse free from 3 months after interferon beta-1b was administered consistently. This case showed that interferon beta had positive effects to reduce relapses in pediatric MS patients, and pediatric MS relapsed during withdrawal of interferon beta for a short period.
참고문헌 (15)
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