Department of Neurology and Neurophysiology, Faculty of Medicine, Medical Center - University of Freiburg, Breisacher Strasse 64, D-79106, Freiburg, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 5, D-79104, Freiburg, Germany.
BMC Neurol. 2018 Jan 31;18(1):14. doi: 10.1186/s12883-018-1018-3.
Some rheumatologic disorders may initially manifest with central nervous system (CNS) affection, mimicking the clinical, magnetic resonance imaging, and cerebrospinal fluid findings of multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, has been found positive frequently in MS patients. However, it is unclear whether the MRZR is helpful to distinguish rheumatologic disorders with CNS involvement (RDwCNS) from MS.
The MRZR was evaluated in patients with RDwCNS (n = 23), MS (n = 46; age and sex matched to patients with RDwCNS), and other inflammatory autoimmune neurological diseases affecting the CNS (OIND; n = 48). Both the stringency levels that have been used in previous MRZR studies, MRZR-1 (≥ 1 of 3 AIs positive) and MRZR-2 (≥ 2 of 3 AIs positive), were applied.
There was no statistically significant difference in the prevalence of positive MRZR between patients with RDwCNS (MRZR-1: 13.0% and MRZR-2: 8.7%, respectively) and OIND (MRZR-1: 22.9% and MRZR-2: 8.3%, respectively). Compared to these two study cohorts, the MS group exhibited significantly higher prevalences of positive MRZR (MRZR-1: 82.6%, MRZR-2: 63.0%; p < 0.005 each).
Considering the high specificity of MRZR-2 for MS found in this study, MRZR-2 can be a useful diagnostic tool for distinguishing MS from RDwCNS or OIND.
一些风湿性疾病最初可能表现为中枢神经系统（CNS）受累，其临床表现、磁共振成像和脑脊液检查结果类似于多发性硬化症（MS）。MRZ 反应（MRZR）由针对麻疹、风疹和水痘带状疱疹病毒的三个各自抗体指数（AI）组成，在 MS 患者中经常呈阳性。然而，尚不清楚 MRZR 是否有助于区分伴有中枢神经系统受累的风湿性疾病（RDwCNS）与 MS。
评估了 RDwCNS 患者（n=23）、MS 患者（n=46；与 RDwCNS 患者年龄和性别匹配）和其他影响中枢神经系统的炎症性自身免疫性神经疾病患者（OIND；n=48）的 MRZR。均应用了之前 MRZR 研究中使用的两种严格程度水平，即 MRZR-1（≥3 个 AI 中有 1 个阳性）和 MRZR-2（≥3 个 AI 中有 2 个阳性）。
RDwCNS 患者（MRZR-1：分别为 13.0%和 MRZR-2：分别为 8.7%）和 OIND 患者（MRZR-1：分别为 22.9%和 MRZR-2：分别为 8.3%）中阳性 MRZR 的患病率无统计学差异。与这两个研究队列相比，MS 组阳性 MRZR 的患病率显著更高（MRZR-1：82.6%，MRZR-2：63.0%；p<0.005 各）。
考虑到本研究中 MRZR-2 对 MS 的高特异性，MRZR-2 可作为区分 MS 与 RDwCNS 或 OIND 的有用诊断工具。
