Difference between revisions of "Acute disseminated encephalomyelitis"

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#redirect [[Neuropathology#Acute_disseminated_encephalomyelitis]]
'''Acute disseminated encephalomyelitis''', abbreviated '''ADEM''', is an uncommon [[neuropathology]] with some similarities with [[multiple sclerosis]].
 
==General==
*Thought to be autoimmune; often associated with/preceded by viral illness.<ref name=pmid17438235>{{cite journal |author=Tenembaum S, Chitnis T, Ness J, Hahn JS |title=Acute disseminated encephalomyelitis |journal=Neurology |volume=68 |issue=16 Suppl 2 |pages=S23–36 |year=2007 |month=April |pmid=17438235 |doi=10.1212/01.wnl.0000259404.51352.7f |url=}}</ref>
*May mimic [[multiple sclerosis]].
 
Treatment:
*Steroids.
*Plasmapheresis.
 
Diagnosis:
*Need to r/o infection (with lumbar puncture).
*No old plaques on imaging (MRI).
 
An acute form exists known as ''acute hemorrhagic leukoencephalitis''<ref>URL: [http://path.upmc.edu/cases/case102/dx.html http://path.upmc.edu/cases/case102/dx.html]. Accessed on: 2 January 2012.</ref> (AKA ''acute necrotizing hemorrhagic encephalomyelitis'').
 
==Microscopic==
Features:<ref>{{Ref PBoD8|1312}}</ref>
*Myelin loss with sparing of axons.
*Inflammation:
**Early: [[neutrophil]]s.
**Late: mononuclear cells (lymphocytes, plasma cells).
*Lipid-laden macrophages.
 
DDx:
*[[Multiple sclerosis]].
**Tend to be larger, more lymphocytes,<ref>{{Ref APBR|423}}</ref> age of the lesions differ.
*Acute necrotizing hemorrhagic encephalomyelitis (ANHE) - if one considers this a separate entity.
*Acute necrotizing encephalopathy.<ref>URL: [http://path.upmc.edu/cases/case619/dx.html http://path.upmc.edu/cases/case619/dx.html]. Accessed on: 26 January 2012.</ref>
 
==See also==
*[[Neuropathology]].
 
==References==
{{Reflist|1}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Neuropathology]]

Latest revision as of 05:33, 10 December 2014

Acute disseminated encephalomyelitis, abbreviated ADEM, is an uncommon neuropathology with some similarities with multiple sclerosis.

General

  • Thought to be autoimmune; often associated with/preceded by viral illness.[1]
  • May mimic multiple sclerosis.

Treatment:

  • Steroids.
  • Plasmapheresis.

Diagnosis:

  • Need to r/o infection (with lumbar puncture).
  • No old plaques on imaging (MRI).

An acute form exists known as acute hemorrhagic leukoencephalitis[2] (AKA acute necrotizing hemorrhagic encephalomyelitis).

Microscopic

Features:[3]

  • Myelin loss with sparing of axons.
  • Inflammation:
    • Early: neutrophils.
    • Late: mononuclear cells (lymphocytes, plasma cells).
  • Lipid-laden macrophages.

DDx:

  • Multiple sclerosis.
    • Tend to be larger, more lymphocytes,[4] age of the lesions differ.
  • Acute necrotizing hemorrhagic encephalomyelitis (ANHE) - if one considers this a separate entity.
  • Acute necrotizing encephalopathy.[5]

See also

References

  1. ↑ Tenembaum S, Chitnis T, Ness J, Hahn JS (April 2007). "Acute disseminated encephalomyelitis". Neurology 68 (16 Suppl 2): S23–36. doi:10.1212/01.wnl.0000259404.51352.7f. PMID 17438235.
  2. ↑ URL: http://path.upmc.edu/cases/case102/dx.html. Accessed on: 2 January 2012.
  3. ↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1312. ISBN 978-1416031215.
  4. ↑ Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 423. ISBN 978-1416025887.
  5. ↑ URL: http://path.upmc.edu/cases/case619/dx.html. Accessed on: 26 January 2012.
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