CategorySymptoms and treatments

Here we Go Again:-)..CCSVI mark II?

Bateman GA, Lechner-Scott J, Carey MF, Bateman AR, Lea RA. Does the venous pressure theory of multiple sclerosis pathophysiology deserve a second chance? Mult Scler Relat Disord. 2021 Sep 13;56:103262. doi: 10.1016/j.msard.2021.103262. The theory that multiple sclerosis is related to venous pressure has been discredited due to previous operator dependent diagnostic criteria and premature attempts...

A new spin on immune reconstitution

We’ve all heard of alemtuzumab induced thyroid autoimmunity; a side effect affecting roughly 30-48% of individuals receiving the treatment. It is believed to occur when immune cells, particularly autoreactive IgG+ memory B cells return early following depletion of the lymphocytes, leading to a breakdown in the immune tolerance towards the thyroid. But, according to this case report, an...

Booster.. Not good news for anti-CD20..Time to get thinking caps on quickly because the same old same old is probably not going to be good enough.

We can learn from other conditions and if they are seeing the same thing to MS they are more likely to be true. Here is a view on arthritis Fagni F, Simon D, Tascilar K, Schoenau V, Sticherling M, Neurath MF, Schett G. COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses. Lancet Rheumatol. 2021 Aug 27. doi: 10.1016/S2665...

The New Normal

Lab lessons: Read the documents and dont rely on the headlines You were talking about getting a vaccine after waiting for B cells to repopulate and someone asked “What was the number for the B cells that met the fully reconstituted level for you?” This asks the questions What is the normal Level of B cells? 2. Why may it be important to know? To answer 2 first. It is increasingly clear to me that...

Antworte die Frage-Answer der Question

If you are interested in the answers to the questions from the MSTCG, which were mainly German-speaking Neuros read on it is open access Wiendl, H., Gold, R., Zipp, F. et al. Multiple sclerosis therapy consensus group (MSTCG): answers to the discussion questions. Neurol. Res. Pract. 3, 44 (2021). Question 1: when should disease-modifying immunotherapy be initiated? Before...

Bowel Dysfunction in MS is Common

As the is more damage in the spinal cord then the innervation between the gut and central nervous sytem becomes damaged to and this may result in bowel dysfunction Prevalence and predictors of bowel dysfunction in a large multiple sclerosis outpatient population: an Italian multicenter study.Alvino B, Arianna F, Assunta B, Antonio C, Emanuele D, Giorgia M, Leonardo S, Daniele S...

Home care..Natalizumab style

During the pandemic, avoiding hospitals has been advantageous. Natalizumab is usualy infused in hospital. In this study they looked at infusing at home and they concluded it was safe and cheaper to infuse at home. However, I would start to ask why bother? Subcutaneous natalizumab has been approved and whilst this will be intially administered in the hosptial environment…I can easily see...

CD20 and COVID-19

The CD20 onslaught continues at a pace and there is no refuting it, anti-CD20 depletion blocks the formation of vaccine response. I have seen this occur irrespective of the vaccine that was used. I am sorry to say if you are on anti-CD20 you are going to see this over and over again…it will be like-water torture, drip, drip, drip. Yep and I control the tap (faucet for our American readers:...

HSCT in London

You can all read this. I am not going to comment the results look good, the 2.5% mortality rate not so good Autologous Haematopoietic Stem Cell Transplantation in Active Multiple Sclerosis: a Real-world Case Series.Nicholas RS, Rhone EE, Mariottini A, Silber E, Malik O, Singh-Curry V, Turner B, Scalfari A, Ciccarelli O, Sormani MP, Olavarria E, Mehra V, Gabriel I, Kazmi MA, Muraro P;...

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