Key result
Interferon-beta initiation triggers rapid neurological decline and ischemic stroke in misdiagnosed primary CNS angiitis.
Case Report (n=1)
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BACKGROUND: Interferon-beta (INF-beta) is effective and used in reducing exacerbation frequency and disease progression in multiple sclerosis. In certain circumstances, INF-beta can lead to rare side effects. AIMS OF THE STUDY: We report the case of a 34-year-old female patient satisfying the McDonald criteria of multiple sclerosis without showing typical pathologic changes in cerebrospinal fluid (CSF). After introduction of INF-beta treatment, she quickly developed further progression of her disseminated neurological symptoms and finally an ischemic cerebral infarction. METHODS: Evaluation of the patient included arterial angiography, magnetic resonance and positron emission tomography, histopathological assessment as well as a broad spectrum of serum and CSF analysis. RESULTS: All diagnostic evaluations and the clinical course revealed evidences for a primary angiitis of the CNS. We discuss the possible worsening due to inappropriate INF-beta treatment in cerebral angiitis promoting severe cerebrovascular insufficiency. CONCLUSION: The authors suggest that all diagnostic multiple sclerosis criteria including typical CSF findings should be ascertained before INF-beta treatment is initiated.
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Bosche et al. (2006) conducted a case report in Primary angiitis of the CNS initially diagnosed as multiple sclerosis (n=1). Interferon-beta (INF-beta) was evaluated on Ischemic cerebral infarction and neurological symptom progression. Interferon-beta initiation in a 34-year-old woman with primary CNS angiitis misdiagnosed as multiple sclerosis was followed by rapid neurological progression and ischemic stroke (n=1).
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