脱髓鞘疾病的鉴别诊断：有哪些新进展？
Differential diagnosis of demyelinating diseases: what's new?
机构信息
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil.
Hospital Sírio-Libanês, Centro de Esclerose Múltipla, São Paulo SP, Brazil.
出版信息
Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):137-142. doi: 10.1590/0004-282X-ANP-2022-S109.
BACKGROUND
Acquired demyelinating disorders lead to overlapping visual, pyramidal, sensory, autonomic, and cerebellar deficits and may lead to severe disability. Early diagnosis and start of treatment are fundamental towards preventing further attacks and halting disability.
OBJECTIVE
In this paper we provide an updated overview of the differential diagnoses of acquired demyelinating disorders.
METHODS
We performed a critical targeted review of the diagnoses of the most prevalent demyelinating disorders: multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD).
RESULTS
We discuss the workup, diagnostic criteria and new biomarkers currently being used for the diagnosis of these disease entities taking into account the particularities of the Brazilian population and healthcare system.
CONCLUSION
A comprehensive analysis of medical history, physical examination, biomedical and imaging data should be performed to obtain differential diagnosis. Diagnostic criteria should be mindfully employed considering ethnic and environmental particularities of each patient.
背景
获得性脱髓鞘疾病导致视觉、锥体、感觉、自主和小脑功能缺陷重叠，并可能导致严重残疾。早期诊断和开始治疗对于预防进一步发作和阻止残疾至关重要。
目的
本文提供了对获得性脱髓鞘疾病的鉴别诊断的最新概述。
方法
我们对最常见的脱髓鞘疾病（多发性硬化症[MS]、视神经脊髓炎谱系障碍[NMOSD]和髓鞘少突胶质细胞糖蛋白抗体病[MOGAD]）的诊断进行了批判性的靶向综述。
结果
我们讨论了目前用于这些疾病实体诊断的检查、诊断标准和新的生物标志物，同时考虑了巴西人群和医疗保健系统的特点。
结论
应全面分析病史、体检、生物医学和影像学数据以获得鉴别诊断。在考虑每个患者的种族和环境特点时，应慎重使用诊断标准。
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