neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2023-4-1-52-58yxnsifneurojour-88Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКонцентрический склероз Бало в педиатрической популяции: обзор литературы и анализ клинических случаевBaló’s concentric sclerosis in the pediatric population: literature review and analysis of clinical cases in the context of follow up observationhttps://orcid.org/0000-0001-6576-1765БыковаОльга ВладимировнаBykovaOlga V.

Доктор медицинских наук, заведующая научно-исследовательским отделом ГБУЗ «ПЦ ДП ДЗМ».

e-mail: avt496709@yandex.ru 

MD, PhD, Scientific and Practical Centre of Pediatric Psychoneurology of Moscow, Moscow, 119602, Russian Federation.

e-mail: avt496709@yandex.ru 

avt496709@yandex.ruhttps://orcid.org/0009-0005-8253-6283КудрявцеваОльга И.KudryavtsevaOlga I.noemail@neicon.ruhttps://orcid.org/0000-0003-3837-1627СаржинаМарина Н.SarzhinaMarina N.noemail@neicon.ruhttps://orcid.org/0000-0003-0928-2131БатышеваТатьяна Т.BatyshevaTatyana T.noemail@neicon.ruГБУЗ «Научно-практический центр детской психоневрологии ДЗМ»РоссияScientific and Practical Centre of Pediatric Psychoneurology of Moscow, Healthcare DepartmentRussian Federation202312052023415258Copyright © Быкова О.В., Кудрявцева О.И., Саржина М.Н., Батышева Т.Т., 20232023Быкова О.В., Кудрявцева О.И., Саржина М.Н., Батышева Т.Т.Bykova O.V., Kudryavtseva O.I., Sarzhina M.N., Batysheva T.T.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/88

Концентрический склероз Бало (КСБ) — редкий вариант атипичной псевдотуморозной демиелинизации, имеющий патогенетическую общность с рассеянным склерозом и характерный нейровизуализационный паттерн при относительной клинической неоднородности. У детей и подростков КСБ встречается реже, чем у взрослых, и представлен в научной литературе единичными описаниями клинических случаев, имеющих полиморфный клинический фенотип и различные анамнестические предпосылки (например, инфекционные). Более того, опубликованные случаи не предполагают анализа длительного клинического катамнеза детей и подростков с данной патологией, возможно, за счёт их перехода по мере взросления во взрослые неврологические службы. Данная выборка не даёт возможности анализа случаев КСБ с педиатрическими дебютами и не отвечает на вопросы о клинических особенностях и терапевтических потребностях таких пациентов. Особенно много скопилось вопросов, касающихся подходов к лечению пациентов с классической, моноочаговой формой КСБ. Дефицит научной и клинической информации тормозит принятие административных решений по назначению таким пациентам терапии препаратами, изменяющими течение рассеянного склероза. С целью пополнения базы педиатрических случаев КСБ мы провели анализ российского опыта длительной (от 2 до 6 лет) курации 3 несовершеннолетних пациентов с острым неинфекционным демиелинизирующим эпизодом и монофокальным концентрическим поражением белого вещества головного мозга. Отечественные данные демонстрируют длительную эффективность и переносимость препаратов, изменяющих течение рассеянного склероза, среди пациентов педиатрического возраста с КСБ.

Участие авторов

Участие авторов:Быкова О.В. — написание текста;Кудрявцева О.И. — редактирование текста;Саржина М.Н. — написание текста;Батышева Т.Т. — написание текста; окончательное утверждение для публикации рукописи.Все авторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила

Поступила: 16.02.2023 Принята к печати: 03.03.2023 Опубликована: 20.04.2023

Baló’s concentric sclerosis is a rare variant of atypical pseudotumor demyelination, having a pathogenetic similarity with multiple sclerosis and a characteristic neuroimaging pattern with relative clinical heterogeneity. In children and adolescents, Baló’s concentric sclerosis even rarer than in adults, is represented in the scientific literature by single descriptions of clinical cases with a polymorphic clinical phenotype and various anamnestic prerequisites (for example, infectious). Moreover, the published cases do not involve the analysis of a long-term clinical following up in children and adolescents with this pathology, possibly due to their transition to adult neurological services as they grow up. This sample does not allow the analysis of cases of Baló’s concentric sclerosis with pediatric debuts and answer questions about the clinical features and therapeutic needs for such patients. Especially a lot of questions have accumulated concerning approaches to the treatment of patients with the classical, mono-focal form of Baló’s concentric sclerosis. The lack of scientific and clinical information hinders the adoption of administrative decisions on prescribing drugs from the PITRS group (drugs that change the course of multiple sclerosis) to such patients. To replenish the literature base of pediatric cases of Baló’s concentric sclerosis, we analyzed the Russian experience of long-term (from 2 to 6 years) curation of three juvenile patients with acute non-infectious demyelinating episode and monofocal concentric lesion of the white matter of the brain. Russian data demonstrate the long-term efficacy and tolerability of drugs from the PITRS group among pediatric patients with Baló’s concentric sclerosis.

Contribution

Contribution:Bykova O.V. — writing the text;Kudryavtseva O.I. — text editing;Sarzhina M.N. — writing the text;Batysheva T.T. — writing the text; final approval for the publication of the manuscript.All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: February 16, 2023Accepted: March 3, 2023Published: April 20, 2023

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The authors declare that there are no conflicts of interest present.