Immune thrombocytopenia (idiopathic thrombocytopenic purpura, ITP) and multiple sclerosis (MS) are two autoimmune diseases (AIDs), and their co-occurrence in a single patient is a rare combination. In recent years, there has been an increase in the prevalence of MS, as well as other AIDs; consequently, comorbid autoimmune conditions in individuals with MS are being observed with increasing frequency and are taking on significant scientific and clinical importance. Managing such patients is particularly challenging, as there is currently no established treatment strategy for patients with MS and concomitant ITP. The scientific literature describes isolated cases of the combination of MS and autoimmune thrombocytopenia, which may indicate shared pathogenetic mechanisms underlying these diseases. This article presents clinical cases illustrating two types of relationship between ITP and MS: primary autoimmune comorbidity of the conditions and secondary druginduced ITP. The widespread use in recent years of disease-modifying drugs (DMDs) and the planned expansion of their spectrum necessitate the stratification of the risks associated with this therapy.
K. Bakhtiyarova, T. D. Yunusov, O. V. Lyutov et al.· Neurology, neuropsychiatry,...· 0 citations
Neuromyelitis optica spectrum disorders (NMOSD) constitute a group of rare, autoimmune and often disabling diseases of the central nervous system. Despite clear diagnostic criteria for NMOSD, diagnostic errors remain a serious problem, leading to delays in necessary treatment and adverse outcomes. This article presents four clinical cases of NMOSD that illustrate the difficulties in making a timely diagnosis due to an ambiguous clinical, radiological and laboratory picture. In these cases, clinical manifestations typical of NMOSD (optic neuritis, acute myelitis and area postrema syndrome) are described; however, the patients were initially referred to specialists in other fields: ophthalmologists, gastroenterologists and neurosurgeons, which led to a delay in their referral to the Multiple Sclerosis Centre and a late diagnosis. The delayed initiation of pathogenetic therapy in two patients led to the development of persistent severe disability as a consequence of NMOSD exacerbations. Factors contributing to the prolonged time to diagnosis were analyzed, and strategies to improve the early diagnosis of NMOSD to prevent such outcomes were proposed.
K. Bakhtiyarova, O. V. Lyutov, T. R. Galiullin et al.· Neurology, neuropsychiatry,...· 0 citations
