Dysimmune Neurological Diseases. SNO: Thanks to Serological Markers, Advances in Diagnosis

PROF. GIOMETTO: “BUT THERE'S STILL A LOT TO DO ON EXPERIMENTAL THERAPIES, WE'RE WORKING ON IT"THE EXPERT AT THE 62ND CONGRESS OF NEUROLOGISTS: "IN YOUNG PEOPLE, PATHOLOGIES ARE OFTEN MISTAKEN FOR PSYCHIATRIC."

They affect the central and peripheral nervous system and can cause even serious disabilities. They are not easy to diagnose and can be confused with depression, mental suffering, somatization syndrome or hypochondria.

Dysimmune neurological diseases are a group of rare conditions that can affect both the central nervous system and the peripheral nervous system. These diseases often affect the ability to walk or grasp objects and cause loss of sensation, tingling, or pain in the hands and feet, or cause seizures and dementia.

Much has been achieved in recent years regarding therapies, but there is still much to be done regarding innovative experimental treatments. This was discussed by Professor Bruno Giometto, of the University of Trento (UNITN) and Director of Neurology at the Santa Chiara Hospital in Trento, speaking today at the 62nd National Congress of the SNO - Hospital Neurological Sciences, underway in Florence. The session title was "Dysimmune Diseases: Emerging Pathologies."

"Among the dysimmune neurological diseases, the best known and most widespread is multiple sclerosis, for which accurate and easily measurable markers have not yet been identified.- said Giometto- In general, however, dysimmune (or autoimmune) diseases have antibodies that can be found in the blood and that allow a correct diagnosis of the disease.

In the last 10 years, in particular, there has been significant progress: while dysimmune encephalopathies were once mistaken for encephalitis, today it has been seen that many of these pathologies are autoimmune and not infectious, thanks to the antibodies that provide us with information.

Despite progress, these pathologies remain difficult to diagnose and require "a great deal of experience on the part of the clinician." However, they now have innovative laboratory tests available, with "specific serological markers, which play an increasingly important role."

As for therapies, according to Dr. Giometto, great steps forward have been made: "There are effective first-line corticosteroid therapies (as well as immunoglobulins or plasmapheresis), but also second-line therapies. The latter are important when we have a definitive diagnosis of the disease, because monoclonal antibodies are injected that block the lymphocytes that produce antibodies. Rituximab, in these cases, is the best option."

According to recent analyses, meanwhile, therapies for dysimmune encephalitis "work" for almost 9 out of 10 patients, but it is equally important to underline that patients to date are still not responding to the new experimental therapies.

"We're still working on it," the expert emphasized. But at what age can dysimmune encephalitis appear, and what are the first signs? "These pathologies affect all age groups, starting from pediatric age.- Dr. Giometto said - In children and young people we mainly find those diseases that appear to be psychiatric but are actually autoimmune, while in adults and the elderly those that present with epileptic seizures and dementia".

Also speaking during the session was Dr. Silvia Casagrande, medical director at the Neurology Unit of the Trento and Rovereto hospital: “Some forms of neurological autoimmune diseases can also be a sign of a tumor that is often not yet detected.

These pathologies, called paraneoplastic neurological syndromes- he explained-sThey often have a worse response to therapy than other autoimmune diseases and their management requires a multidisciplinary approach. However, their correct classification can lead to an early diagnosis of an oncological disease- concluded Casagrande- cwith consequent improvement in the prognosis of the tumor”.