Nakamura Masataka, Itani Kumi, Miyake Kousuke, Kunieda Takenobu, Kaneko Satoshi, Kusaka Hirofumi
Department of Neurology, Kansai Medical University, Japan.
Intern Med. 2017;56(2):211-214. doi: 10.2169/internalmedicine.56.7588. Epub 2017 Jan 15.
We herein report the case of a 57-year-old woman presenting with a biopsy-proven tumefactive demyelinating lesion as her first clinical event. Subsequently, she displayed a relapsing-remitting course with recurrence of large demyelinating lesions exceeding 2 cm in diameter rather than the small ovoid lesions characteristic of multiple sclerosis. Administration of interferon beta did not suppress the disease activity. Finally, treatment with natalizumab, which is a humanized monoclonal antibody against the cell-adhesion molecule α4-integrin, was initiated, resulting in clinical and radiological stabilization. Our experience here suggests that natalizumab may be an effective therapeutic option for relapsing-remitting tumefactive multiple sclerosis with high disease activity.
我们在此报告一例57岁女性患者,其首次临床症状为经活检证实的瘤样脱髓鞘病变。随后,她表现为复发-缓解病程,复发时出现直径超过2 cm的大型脱髓鞘病变,而非多发性硬化特征性的小卵圆形病变。使用β-干扰素治疗未能抑制疾病活动。最后,开始使用那他珠单抗治疗,那他珠单抗是一种针对细胞黏附分子α4整合素的人源化单克隆抗体,治疗后实现了临床和影像学稳定。我们在此的经验表明,对于疾病活动度高的复发-缓解型瘤样多发性硬化,那他珠单抗可能是一种有效的治疗选择。