Radyolojik İzole Sendrom
Özet
Radyolojik İzole Sendrom (RİS), multipl sklerozu (MS) düşündüren demiyelinizan lezyonların, hiçbir klinik belirti olmaksızın tesadüfen saptanmasıdır. Bu durum, gelecekte olası MS gelişimini işaret ettiği için önemlidir. Özellikle pediatrik hastalarda nadir görülmesine rağmen, RİS tanısı alanların bir kısmında ilerleyen dönemde klinik MS ortaya çıkabilir. Bu nedenle erken tanı ve uygun takip, hastalığın seyrini değiştirme potansiyeline sahiptir. Lezyonların MRG dağılımı, spinal kord tutulumunun varlığı ve oligoklonal bant pozitifliği MS’e dönüşme riskini artıran temel etmenlerdir. Ek olarak genç yaş ve erkek cinsiyet, daha yüksek ilerleme olasılığı ile ilişkilendirilmektedir. RİS’li bireylerin yaklaşık üçte birinde, beş yıl içinde ilk klinik atak meydana geldiği raporlanmıştır. Tedaviye erken başlamak konusunda kesin bir fikir birliği olmamakla birlikte, bazı çalışmalar erken müdahalenin MS’e geçişi geciktirebileceğini göstermektedir. Bu nedenle RİS tanısı konan olguların düzenli aralıklarla klinik ve radyolojik takipleri önerilmektedir.
Radiologically Isolated Syndrome (RIS) is defined as the incidental detection of demyelinating lesions suggestive of multiple sclerosis (MS) in the absence of any clinical symptoms. This condition is significant because it may indicate a potential future development of MS. Although rare in pediatric patients, some individuals diagnosed with RIS may progress to clinical MS over time. Therefore, early diagnosis and appropriate monitoring have the potential to alter the course of the disease. The distribution of lesions on MRI, the presence of spinal cord involvement, and positive oligoclonal bands are key factors that increase the risk of progression to MS. Additionally, younger age and male gender are associated with a higher likelihood of progression. It has been reported that approximately one-third of individuals with RIS experience their first clinical attack within five years. Although there is no clear consensus on initiating early treatment, some studies suggest that early intervention may delay the transition to MS. For this reason, regular clinical and radiological follow-up is recommended for individuals diagnosed with RIS.
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