Marburg's variant multiple sclerosis

Marburg's variant of multiple sclerosis, also known as Marburg multiple sclerosis or acute fulminant multiple sclerosis, is considered one of the multiple sclerosis borderline diseases, which is a collection of diseases classified by some as MS variants and by others as different diseases. Other diseases in this group are neuromyelitis optica (NMO), Balo concentric sclerosis, and Schilder's disease.[1] The graver course is one form of malignant multiple sclerosis, with patients reaching a significant level of disability in less than five years from their first symptoms, often in a matter of months.[2]

It took its name from Otto Marburg. It can be diagnosed in vivo with an MRI scan.[3] If Marburg disease occurs in the form of a single large lesion, it can be radiologically indistinguishable from a brain tumor or abscess. In such cases, craniotomy and biopsy are needed to exclude other pathologies.[4] It is usually lethal, but it has been found to be responsive to Mitoxantrone[5] and Alemtuzumab,[6] and it has also been responsive to autologous stem cell transplantation.[7] Recent evidence shows that Marburg's presents a heterogeneous response to medication, as does standard MS.[8]

Sometimes Marburg MS is considered a synonym for tumefactive MS.[9] but not for all authors[10]

Prognosis

Marburg variant of MS is an acute fulminant demyelinating process which in most cases progresses inexorably to death within 1–2 years.[11] However, there are some reports of Marburg MS reaching stability by three years.[12]

See also

References

  1. ↑ Fontaine B (2001). "Borderline forms of multiple sclerosis". Rev. Neurol. (Paris) (in French). 157 (8–9 Pt 2): 929–34. PMID 11787357.
  2. ↑ Lublin FD, Reingold SC (April 1996). "Defining the clinical course of multiple sclerosis: Results of an international survey". Neurology. 46 (4): 907–11. doi:10.1212/WNL.46.4.907. PMID 8780061.
  3. ↑ Capello E, Mancardi GL (November 2004). "Marburg type and Balò's concentric sclerosis: rare and acute variants of multiple sclerosis". Neurol. Sci. 25 (Suppl): S361–3. doi:10.1007/s10072-004-0341-1. PMID 15727234.
  4. ↑ Walid MS, Sanoufa M (2010). "The diagnosis of Marburg Disease is course-dependent". GMS Ger Med Sci.
  5. ↑ Jeffery DR, Lefkowitz DS, Crittenden JP (January 2004). "Treatment of Marburg variant multiple sclerosis with mitoxantrone". J Neuroimaging. 14 (1): 58–62. doi:10.1111/j.1552-6569.2004.tb00217.x. PMID 14748210.
  6. ↑ Gormley KM, Zajicek JP (2006). "Alemtuzumab and craniotomy for severe acute demyelinating illness". 16th Meeting of the European Neurological Society.
  7. ↑ Kimiskidis VK, Sakellari I, Tsimourtou V, et al. (2007). "Autologous stem cell transplantation in malignant multiple sclerosis: a case with a favorable long-term outcome". Multiple Sclerosis. 14 (2): 278–83. doi:10.1177/1352458507082604. PMID 17942513.
  8. ↑ Leussink VI, Lehmann HC, Meyer Zu Hörste G, Hartung HP, Stüve O, Kieseier BC (2008). "Rituximab induces clinical stabilization in a patient with fulminant multiple sclerosis not responding to natalizumab: Evidence for disease heterogeneity". Journal of Neurology. 255 (9): 1436–8. doi:10.1007/s00415-008-0956-x. PMID 18685916.
  9. ↑ See explanation at
  10. ↑ Ayumi Ludwig et al, Marburg’s Variant of Multiple Sclerosis with Extensive Brain Lesions: An Autopsy Case Report. Int J Neurol Neurother 2015, 2:2
  11. ↑ Dan L. Longo, et.al, ed. (2012). Harrison's principles of internal medicine. (18th ed.). New York: McGraw-Hill. p. 3407. ISBN 9780071748896.
  12. ↑ Turatti, M; Gajofatto, A; Rossi, F; Vedovello, M; Benedetti, MD (Dec 2010). "Long survival and clinical stability in Marburg's variant multiple sclerosis.". Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 31 (6): 807–11. doi:10.1007/s10072-010-0287-4. PMID 20461429.

External links

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