Pediatrik Multipl Skleroz Tanı ve Tedavi Algoritması
Özet
Multipl skleroz (MS), santral sinir sisteminin multifokal ve multifazik seyreden, başka bir hastalıkla açıklanamayan demiyelinizan bir hastalığıdır. Tanıda, 2017 McDonald kriterleri ile alanda ve zamanda yayılımın gösterilmesi gerekmektedir. Son yıllarda MS patogenezindeki gelişmeler doğrultusunda 2024 ECTRIMS önerileri tanı sürecine yeni biyobelirteçler (örneğin, kappa serbest hafif zincir) ve görüntüleme bulgularını (santral ven işareti, paramagnetik rim lezyonları) dahil etmeyi önermektedir. MS tanısı konulan çocuk hastalarda tedavi, akut atak yönetimi ve hastalık modifiye edici tedavileri kapsar. Erken tanı ve tedavi, uzun vadede özürlülüğü önlemek açısından kritik öneme sahiptir. Multidisipliner bir yaklaşım, bilişsel ve psikososyal desteğin sağlanması ve düzenli takip ile hastalık yönetimi optimize edilmelidir.
Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system that follows a multifocal and multiphasic course and cannot be explained by another condition. Diagnosis requires demonstrating dissemination in space and time according to the 2017 McDonald criteria. In recent years, advancements in MS pathogenesis have led to the 2024 ECTRIMS recommendations, which propose incorporating new biomarkers (e.g., kappa free light chains) and imaging findings (central vein sign, paramagnetic rim lesions) into the diagnostic process.
In pediatric patients diagnosed with MS, treatment encompasses acute attack management and disease-modifying therapies. Early diagnosis and treatment are crucial in preventing long-term disability. A multidisciplinary approach, including cognitive and psychosocial support and regular follow-up, is essential for optimizing disease management
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