PMID- 30229853
OWN - NLM
STAT- MEDLINE
DCOM- 20191219
LR  - 20191219
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 22
IP  - 17
DP  - 2018 Sep
TI  - Childhood multiple sclerosis: clinical features and recent developments on 
      treatment choices and outcomes.
PG  - 5747-5754
LID - 15843 [pii]
LID - 10.26355/eurrev_201809_15843 [doi]
AB  - Multiple sclerosis (MS) is an inflammatory idiopathic autoimmune disease causing 
      demyelination of central nervous system (CNS). The incidence of pediatric MS is 
      relatively rare, affecting 0.2 to 0.64/100,000 subjects; cases with MS onset 
      before age 10-12 years, account for less than 1% of all MS cases, while 2.7 to 
      10.5% of all MS cases worldwide are seen in children <18 years of age, with a 
      strong female preponderance. The disease course of MS varies from a benign type 
      with relatively low level of disability after a long duration (15 years) of the 
      disease, to a malignant type of MS with severe disability or even death within 
      few months following onset. Diagnostic criteria for pediatric MS include >/= 2 
      clinical events involving more areas of CNS inflammation in the absence of 
      encephalopathy, separated by > 30 days, along with the involvement of brainstem. 
      Pediatric MS generally presents relapsing-remittent form of MS, with majority of 
      the patients recovering from the first attack. Major histocompatibility complex, 
      more specifically, mutations in the human leukocyte antigen (HLA) DRB1*15 allele, 
      are considered most important genetic factors that are contributory to the 
      disease. Treatment choices for pediatric MS include many disease-modifying 
      therapies (DMT) that are currently being used for adult MS and these are 
      interferon-beta 1a/1b (IFN-beta1a/1b), glatiramer acetate, teriflunomide, dimethyl 
      fumarate, alemtuzumab, etc. However, most of these have not gone through complete 
      testing in randomized, placebo-controlled clinical trials for pediatric MS and 
      are being prescribed off-label by clinicians. As these studies are progressing, 
      it is important to address if these approaches of treating pediatric MS patients 
      have any long-term impact on patients, in particular, physical, cognitive, 
      developmental and social outcomes of the children.
FAU - An, Q
AU  - An Q
AD  - Department of Internal Medicine, Xuzhou Children's Hospital, Xuzhou, Jiangsu, 
      P.R. China. fanconghai020@163.com.
FAU - Fan, C-H
AU  - Fan CH
FAU - Xu, S-M
AU  - Xu SM
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (HLA-DRB1 Chains)
RN  - 0 (HLA-DRB1*15 antigen)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Adolescent
MH  - Age of Onset
MH  - Child
MH  - Clinical Decision-Making
MH  - Disease Progression
MH  - Female
MH  - Genetic Predisposition to Disease
MH  - HLA-DRB1 Chains/genetics/immunology
MH  - Humans
MH  - Immunologic Factors/adverse effects/*therapeutic use
MH  - Male
MH  - Multiple Sclerosis, Relapsing-Remitting/diagnosis/*drug 
      therapy/epidemiology/immunology
MH  - Mutation
MH  - Patient Selection
MH  - Phenotype
MH  - Remission Induction
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2018/09/20 06:00
MHDA- 2019/12/20 06:00
CRDT- 2018/09/20 06:00
PHST- 2018/09/20 06:00 [entrez]
PHST- 2018/09/20 06:00 [pubmed]
PHST- 2019/12/20 06:00 [medline]
AID - 15843 [pii]
AID - 10.26355/eurrev_201809_15843 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2018 Sep;22(17):5747-5754. doi: 
      10.26355/eurrev_201809_15843.