title: Persistence of immunopathological and radiological traits in multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a heterogeneous autoimmune disease of the central nervous system. The identification of 4 different immunopathological subtypes of MS raises the question of whether these subtypes represent different patient subgroups that can be distinguished according to their leading mechanism of myelin destruction or whether this is a stage-dependent process in the development of lesions in a given patient.
  
  
  OBJECTIVE
  To document intraindividual immunopathological and radiological homogeneity of 2 different lesions in a single patient with relapsing-remitting MS over time.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A neuropathological referral center for inflammatory demyelinating diseases of the central nervous system.
  
  
  METHODS
  A 49-year-old woman with clinically definite relapsing-remitting MS.
  
  
  METHODS
  Radiological and immunopathological analysis of MS lesions.
  
  
  RESULTS
  Identical pathological findings in 2 different MS lesions separated by more than 2 years were identified. These lesions displayed similar and distinct radiological features on cranial imaging.
  
  
  CONCLUSIONS
  In this patient we were able to show the same antibody/complement-mediated lesion pathological findings with compatible identical ring enhancement on T1-weighted magnetic resonance images and hypointense rims on T2-weighted images after an interval of 26 months. Our observations support the concept of intraindividual homogeneity of a given immunopathological MS subtype.
authors.affiliation: Department of Neuropathology, University Medical Center Göttingen, Göttingen, Germany. fkoenig@med.uni-goettingen.de
authors.forename: Fatima B
authors.initials: FB
authors.lastname: König
authors.forename: Brigitte
authors.initials: B
authors.lastname: Wildemann
authors.forename: Stefan
authors.initials: S
authors.lastname: Nessler
authors.forename: Dun
authors.initials: D
authors.lastname: Zhou
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hemmer
authors.forename: Imke
authors.initials: I
authors.lastname: Metz
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Kieseier
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Brück
mesh_terms: D000906:Antibodies / Q000097:blood; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D009185:Myelin Proteins; D018992:Myelin-Associated Glycoprotein / Q000276:immunology; D063308:Myelin-Oligodendrocyte Glycoprotein; D010296:Parietal Lobe / Q000473:pathology; D013997:Time Factors
chemical_list: D000906:Antibodies; D007074:Immunoglobulin G; C571326:MOG protein, human; D009185:Myelin Proteins; D018992:Myelin-Associated Glycoprotein; D063308:Myelin-Oligodendrocyte Glycoprotein