Publications by authors named "Ryotaro Ikeguchi"

Background: Few studies have examined B cells among patients with anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), including brain pathology.

Objective: To describe cases of tumefactive MOGAD with B-cell dominant central nervous system (CNS) infiltration.

Methods: In this study, we reviewed three cases with clinical and brain histopathological features with tumefactive MOGAD.

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Here, we report a case of antineutrophil cytoplasmic antibody (ANCA)-associated central nervous system (CNS) vasculitis that mimicked a brain tumor. The patient presented with progressive right upper arm weakness. Brain magnetic resonance imaging (MRI) revealed large tumor-like lesions in the left frontal and parietal lobes, with patchy and irregular enhancement with gadolinium and edema.

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Article Synopsis
  • * Four case studies of pregnant women show that DMF was stopped early in pregnancy but resumed postpartum, while NTZ dosing was modified; neither group experienced relapses within a year after giving birth.
  • * The findings suggest that DMF and NTZ are not contraindicated during pregnancy, but close monitoring is necessary due to the lack of extensive safety data from randomized trials.
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Chronic cerebrospinal fluid leak with spinal cord compression can mimic the symptoms of ALS, with a snake-eyes appearance on MRI.

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Background This study aimed to clarify the need for disease-modifying drug (DMD) treatment in elderly patients with multiple sclerosis (MS) aged 50 years or older. MS is an autoimmune, demyelinating disease of the central nervous system that predominantly affects young women. Various DMDs are effective in preventing relapses and slowing the progression of disability in patients with MS.

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Rhabdomyolysis is a known side effect of levetiracetam. In general, a patient with rhabdomyolysis complains of muscle pain and swelling. Herein, we report four cases of asymptomatic levetiracetam-induced rhabdomyolysis.

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Although immune checkpoint inhibitors (ICIs) are widely used to treat unresectable malignant tumors, they can cause undesirable side effects called immune-related adverse events, including neurological toxicities. Here, we describe a case of ICI-related peripheral neuropathy (irPN) with characteristic cerebrospinal fluid (CSF) findings. In addition to pleocytosis and increased protein levels, the present case showed increased levels of CSF soluble interleukin-2 receptor (sIL-2R), IL-6, and IL-10, suggesting activated T cell-related autoimmunity.

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Here, we report a case of IgG4-related brain pseudotumor (IgG4-BP) in a 39-year-old woman, mimicking central nervous system (CNS) lymphoma. She presented with headache, fever, and fatigue. Her medical history was notable for appearance of a tumefactive brain lesion seven years before.

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Background And Objective: To elucidate the relationship between melanoma cell adhesion molecule (MCAM)-expressing lymphocytes and pathogenesis of CNS inflammatory demyelinating diseases (IDDs).

Methods: Patients with multiple sclerosis (MS) (n = 72) and neuromyelitis optica spectrum disorder (NMOSD, n = 29) were included. We analyzed the frequency and absolute numbers of MCAM lymphocytes (memory helper T [mTh] cells, naive helper T cells, CD8 T cells, and B cells) in the peripheral blood (PB) and the CSF of patients with MS and NMOSD, treated with/without disease-modifying drugs (DMDs) or steroids, using flow cytometry.

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Article Synopsis
  • * Methodology: It includes a detailed case analysis of a 27-year-old woman, alongside a review of five similar cases.
  • * Findings: The patient exhibited severe neurological symptoms, confirmed NMOSD diagnosis through tests, and showed improvement post-treatment for both the disorder and teratoma, indicating a connection that warrants further investigation into the relationship between ovarian teratoma and NMOSD.
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  • Eculizumab, a monoclonal antibody targeting complement protein C5, has shown effectiveness and tolerability in treating anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis (gMG), particularly in a study known as REGAIN.
  • In a study involving 1388 patients with myasthenia gravis, only 12 received eculizumab, with most showing significant improvements in disease severity and quality of life after 26 weeks of treatment.
  • Despite its benefits, a small number of patients were treated with eculizumab, indicating a lack of consensus on its selection criteria for patients with gMG.
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Immunoglobulin G4-related disease (IgG4)-related disease is a newly recognized form of immune-mediated disease, which is characterized by IgG4+ lymphoplasmacytic infiltration and fibrosis in the systemic organs. Although aortitis/periaortitis is a phenotype of IgG4-related disease, the relationship between cerebrovascular disease and IgG4-related disease remains unclear. Herein, we report the case of a 49-year-old man with recurrent stroke induced by IgG4-related arteritis.

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Background: It is often difficult to accurately differentiate tumefactive demyelinating lesions (TDLs) from gliomas using MRI.

Objective: To investigate the utility of proton magnetic resonance spectroscopy (MRS) in differentiating TDLs from gliomas.

Methods: Cohort 1 included 6 patients with TDLs and 5 with gliomas (3 high-grade), as assessed using a 1.

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Background: It is often difficult to diagnose central nervous system (CNS) inflammatory demyelinating diseases (IDDs) because they are similar to CNS lymphoma and glioma.

Objective: To evaluate whether cerebrospinal fluid (CSF) analysis can differentiate CNS IDDs from CNS lymphoma and glioma.

Methods: We measured CSF cell counts; concentrations of proteins, glucose, interleukin (IL)-6, IL-10, soluble IL-2 receptor (sIL-2R), and myelin basic protein; and IgG index in patients with multiple sclerosis (MS, n = 64), neuromyelitis optica spectrum disorder (NMOSD, n = 35), tumefactive demyelinating lesion (TDL, n = 17), CNS lymphoma ( n = 12), or glioma ( n = 10).

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Background: The incidence of concurrent myasthenia gravis (MG) and neuromyelitis optica spectrum disorder (NMOSD) is higher than what chance predicts, yet it remains unclear why MG and NMOSD appear concurrently.

Objective: The purpose of the present study was to examine the clinical features of the concurrence of these diseases.

Methods: Clinical details were analyzed retrospectively.

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Osteopontin (OPN) up-regulates pro-inflammatory cytokines from both T helper type 1 and T helper type 17 cell pathways. We measured plasma OPN levels in Japanese multiple sclerosis (MS) and neuromyelitis optica (NMO) patients to investigate its value as a potential biomarker of disease activity. In NMO patients, plasma OPN levels were significantly higher than those in healthy individuals, being equivalent to those in MS patients.

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We report the case of a young woman with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, without tumor, who was successfully treated with rituximab. Because conventional immunotherapy, including corticosteroids, immunoglobulin (IVIg), and plasma exchange showed little improvement in our patient, we introduced another treatment using rituximab. A week after the first administration of rituximab, her symptoms improved gradually and significantly.

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