Miskin Dhanashri P, Saadi Altaf, Chikoya Laston, Sloane Jacob A, Koralnik Igor J, Siddiqi Omar K
Division of Neuro-Immunology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, USA.
Partners Neurology Residency, Massachusetts General Hospital, Brigham and Women's Hospital, USA.
Mult Scler J Exp Transl Clin. 2016 Jul 4;2:2055217316657117. doi: 10.1177/2055217316657117. eCollection 2016 Jan-Dec.
Demyelinating disease occurs in a population of black adult Zambians whose genetic and environmental risk factors for multiple sclerosis are thought to be rare. The diagnosis of demyelinating disease was based predominantly on compatible clinical history and neurologic exam findings, and in some cases, more definitely established by cerebrospinal fluid exam and imaging findings. When available, laboratory studies excluded other known causes of CNS demyelination. Timely evaluation and treatment with disease-modifying therapies was related to the patient's employment status. Lack of financial means to go abroad was a major hurdle in a patient's ability to receive treatment. Significant barriers often prohibit timely diagnosis and prevent proper management of these patients.
脱髓鞘疾病发生在一群成年赞比亚黑人中，他们被认为患多发性硬化症的遗传和环境风险因素很少见。脱髓鞘疾病的诊断主要基于相符的临床病史和神经系统检查结果，在某些情况下，通过脑脊液检查和影像学检查结果能更明确地确诊。如有可能，实验室检查排除了中枢神经系统脱髓鞘的其他已知病因。使用疾病修正疗法进行及时评估和治疗与患者的就业状况有关。缺乏出国的资金是患者接受治疗能力的一个主要障碍。重大障碍往往阻碍及时诊断，并妨碍对这些患者进行妥善管理。
