Article

Pediatric-onset multiple sclerosis (POMS) has distinctive features compared with
adult-onset multiple sclerosis (AOMS), and warrants caution despite being a rare
form of MS. POMS diagnostic criteria are somewhat different from those used in
AOMS, with acute disseminated encephalomyelitis being a key differential
diagnosis of MS in children. Other differential diagnoses that have to be ruled
out before diagnosing MS include demyelinating syndromes, autoimmune and systemic
pathologies, and infectious, genetic, metabolic and neoplastic diseases. Compared
with AOMS, POMS has several different clinical, biological and imaging findings.
At onset, high-level inflammatory activity is mainly reported, and patients with
POMS are also at high risk of developing early physical disabilities and early
cognitive impairment. Yet, treating patients with POMS is challenging due to a
lack of randomized controlled trials. Some of the disease-modifying drugs
currently prescribed are analogous to therapies used in adults, and are
associated with good tolerability in pediatric patients. However, a few clinical
trials dedicated to POMS are now in progress, and the future outlook is to
improve the long-term prognosis of POMS patients with early effective and safe
treatments.
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