Questions discussed in this category
How long do you monitor before re-treatment or moving to another agent like IVIG?
Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies?
What criteria do you use to distinguish tumefactive MS from non-tumefactive MS?
Is it dependent on which DMT the patient is on?
In light of recent publication by Bsteh et al., PMID 39197111 that examined the outcomes in the treatment of RMS based on isolated MRI findings.
If not, are there any serum or CSF tests you consider to be helpful?
E.g., a patient with newly diagnosed CIDP who is wheelchair-bound.
Is a biopsy or EMG helpful in confirming the etiology? What is the best treatment for sarcoid neuropathy?
Does this ever prompt you to change DMTs?
Question asked in light of Langer-Gould et al., PMID 38507657.
Specifically, do you check for any of these: ACE, Vitamin D 1,25, serum lysozyme, soluble IL2 or Adenosine deaminase levels?
For example, the patient may have other findings such as an elevated CRP. Would you diagnose SLE, or would you want to see other serologies or finding...
Does the number of bands matter in making the diagnosis? Does it make a difference whether isolated or also in the serum? How do you interpret other r...
Are there emerging biomarkers that help distinguish the phenotypes in the absence of evaluation over time?
E.g., JC virus antibody titer, absolute lymphocyte count, etc.
Do you treat with only an IV steroid pulse or do you use an oral steroid taper as well? How long of a taper do you typically use?
In addition, what formula do you use to calculate the IgG index?
Are there any instances where you would prefer a biosimilar rather than the reference product?
Anecdotally, the diagnostic yield in these patients seems quite low, yet autoimmune encephalitis is often invoked in such patients, particularly in th...
If a patient has classic TM symptoms but a normal MRI, are there specific causes you look for?
When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?
How do you approach low IgG levels on these medications?
Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?
Based on this review (Melamed and Lee, PMID 31998289), patients with MS on several DMTs may be at higher risk for certain cancers. How does this play ...
For example, a GAD65 Ab of 0.07 when the cut-off is 0.02. Does this answer change if you consider adult vs pediatric populations?
Instead of waiting for the antibody test to result, if you have a high suspicion for NMDAR encephalitis, is there a role for giving rituximab alongsid...
What is the diagnostic yield and complication rate in your experience?
Do you wait for a second clinical event or start immunomodulatory therapy right away?
Specifically, what do you do if there is minimal improvement with IV steroids and/or IVIG?
Are there any specific patient populations that you are no longer routinely recommending to start B-cell depleting medications? For example, are you l...
Based on the results of the recent longitudinal analysis linking EBV infection and MS (Bjornevik et al., PMID 35025605), can negative EBV antibodies (...
For example, a clinically stable patient on eculizumab, do you continue it indefinitely?
Ex. optical coherence tomography, visual-evoked potentials
Thoughts on sarilumab vs methotrexate, or just treat with steroids alone
Small study in pediatric PACNS have evaluated this as a potential marker (Cellucci et al., PMID 22740622)
If not, how often do you repeat pelvic imaging?
Do you approach things differently if a rare variant like this is suspected? Is the Balo's subtype more similar to RRMS or PPMS?
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Mult Scler Relat Disord, 2020 Dec 16
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Muscle & nerve, 2013-04
Muscle & nerve, 2016-08
Muscle & nerve, 2017-07
Annals of neurology, 2017-07
Front Neurol, 2019 Jun 06
Neurology(R) neuroimmunology & neuroinflammation, 2017-07
J Med Life,
J Clin Neurol, 2018 Feb 28
Mult Scler, 2014 Mar 03
Mult Scler Relat Disord, 2016 Dec 23
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Lancet, 2016 Mar 04
Arthritis Rheum,
Journal of neurovirology, 2018-06
Neurology, 2019 Jan 11
The Lancet. Neurology, 2013-06
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Neuroepidemiology, 2007 Sep 11
The Lancet. Neurology, 2014-02
The New England journal of medicine, 2017-01-19
N Engl J Med,
J Allergy Clin Immunol, 2022 Feb 14
Mult Scler Relat Disord, 2021 Sep 04
Muscle & nerve, 2007-01
Annals of neurology, 1990-03
Rheum Dis Clin North Am, 2017 Aug 23
Neurology,
Medicine (Baltimore),
Muscle Nerve, 2014 Dec 23
Archives of ophthalmology (Chicago, Ill. : 1960), 1988-08
Neurology, 2011-01-18
The Lancet. Neurology, 2016-04
Lancet Neurol, 2020 Nov 23
Clin Microbiol Infect, 2018 Feb 07
Arthritis & rheumatology (Hoboken, N.J.), 2018-03
Neurology, 2021 Oct 05
Neurology, 2017-11-14
Neurol Neuroimmunol Neuroinflamm, 2020 Jul 27
Arthritis and rheumatism, 2009-11
Rheumatology (Oxford), 2014 Oct 21
Cureus, 2019 Aug 19
J Rheumatol, 2007 Sep 15
Rheumatol Int, 2007 Jul 20
Lupus, 2017 Feb 26
Blood, 2020 Jun 18
Clinical immunology (Orlando, Fla.), 2023 Jul 04
Neurology, 2014 May 28
Nature communications, 2020 Feb 10
Journal of clinical neurology (Seoul, Korea), 2024 Jan
JAMA neurology, 2018-12-01
Journal of neuroimmunology, 2022 Apr 09
Neurology(R) neuroimmunology & neuroinflammation, 2021 Oct 04
Lung, 2015 Nov 13
Biomolecules, 2022 Sep 30
Critical reviews in clinical laboratory sciences, 2022 Mar 11
The New England journal of medicine, 2003-10-16
Immunol Invest, 1985 Jun
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Rheumatology (Oxford, England), 2021 Nov 03
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Neurology(R) neuroimmunology & neuroinflammation, 2024 Mar 20
The Lancet. Neurology, 2022 Aug
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Neurology(R) neuroimmunology & neuroinflammation, 2022 Mar 08
Neurology, 2024 Aug 28