Pediatrik Multipl Sklerozda Ayırıcı Tanı
Özet
Pediatrik başlangıçlı multipl skleroz (PBMS) tanısı diğer olası nedenlerin dışlanmasıyla konulur. PBMS’in ayırıcı tanısı oldukça geniş bir yelpazededir ve bu durum özellikle ilk başvuruda tanısal zorluklara neden olabilir. Edinilmiş demiyelinizan sendromlardan Nöromiyelitis optika spektrum bozukluğu (NMOSB), miyelin oligodentrosit glikoprotein ilişkili hastalık (MOGAD), akut dissemine ensefalomiyelit (ADEM) veya monofazik hastalıklar ile birlikte inflamatuvar ve non-inflamatuvar birçok hastalık PBMS’in ayırıcı tanısında yer alır. Nörometabolik, mitokondriyal ve neoplastik hastalıklar MS’i taklit edebilirken, enfeksiyöz hastalıklar ayırıcı tanıda düşünülmelidir. PBMS’in tanısında ve diğer hastalıklardan ayırt edilmesinde, öykü, sistemik ve nörolojik muayene, beyin ve spinal MR görüntüleme bulguları, kan ve beyin omurilik sıvısı analizleri önemli role sahiptir.
Pediatric-onset multiple sclerosis (POMS) is diagnosed by excluding other potential causes. The differential diagnosis of POMS is quite broad, which can lead to diagnostic challenges, particularly at the initial presentation. Acquired demyelinating syndromes such as neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein-associated disease (MOGAD), acute disseminated encephalomyelitis (ADEM), or monophasic illnesses, along with numerous inflammatory and non-inflammatory diseases, are included in the differential diagnosis of POMS. Neurometabolic, mitochondrial, and neoplastic diseases can mimic MS, while infectious diseases should also be considered in the differential diagnosis. In the diagnosis of POMS and its differentiation from other diseases, history, systemic and neurological examination, brain and spinal MRI findings, blood and cerebrospinal fluid analyses play a critical role.
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