INFECTIOUS VASCULITIS IN THE PATHOGENESIS OF DEMYELINATING DISEASES OF THE CENTRAL NERVOUS SYSTEM IN CHILDREN

Abstract

Sixty-nine children with demyelinating diseases of CNS aged from 5 to 17 years were examined. Etiological diagnostics was performed using the polymerase chain reaction, immune cytochemistry and enzyme immunoassay techniques. The brain and spinal cord magnetic resonance imaging (MRI) was performed, and desquamated circulating endotheliocytes and D-dimer levels in blood were determined on the day of admission to the hospital, on the 30th day, in 3 and 6 months. Significantly higher desquamated circulating endotheliocytes and D-dimer levels were established during the acute course of demyelinating diseases of the central nervous system vs. the prolonged and especially chronic one. Pathogens were detected in 87% of patients: in the form of either mono (in 58%) or mixed infections (in 42% of cases). It was found that if viruses are isolated in blood and/or cerebrospinal fluid after therapy in 3 and 6 months, the desquamated circulating endotheliocyte level remains elevated in patients, and with negative results, desquamated circulating endotheliocytes and D-dimer levels are normalized. The highest D-dimer values are observed in patients with hemorrhagic inflammatory sites on MRI, and significantly higher mean values of desquamated circulating endotheliocytes are found in patients with multiple contrasting foci on MRI scans. It is assumed that the main target in children with demyelinating CNS diseases are cerebral venules, the lesion of which is interrelated with the course of the infectious process of herpes virus aetiology in 80% of cases.

Keywords

• дети
• цнс
• демиелинизирующие заболевания
• васкулит
• вирусная инфекция
• десквамированные циркулирующие эндотелиоциты
• д-димер