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*Type 4 hypersensitivity
*MBP [ Myelin Basic Protein ] is the auto-antigen involved in MS
*Mediated by TH1 and TH17
*Unusual immunologic occurrence, as the CNS should be immune-privileged
*Deficiency of IFN-y does not protect from development of **EAE**
*Tregs also have suppressed ability to inhibit autoreactive cells
Patients Signs and Symptoms
*Loss of vision or visual acuity
*Optic neuritis
*Weakness of facial muscles
*Eventually: Slurred speech, weak limbs, nystagmus, and ataxia
Clinical Tests
*MRI reveals multiple lesions in the white matter of the brain under the cortex and around the ventricles
*MRI reveals lesions in the **left middle cerebellar peduncle** and pons
-Gadolinium stains new lesions RED and old lesions yellow
*Increased lymphocytes in CSF { WBC }
*Normal protein in CSF
*Increased IgG IGGGGGGGGGGGGGGG
*Plaques reveal dissolution of myelin and infiltrates of macrophages and lymphocytes along BVs
Genetic Link
*Associated with HLA-DR2
Treatment
*IV corticosteroids [ 5 day vision treatement --- vision restored ]
*IM injections of IFN-B in relapse
*Cyclophospamides
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