A new automated uric acid assay.

Abstract

<h3>Objective:</h3> To present a case series of multiple sclerosis (MS) patients where a previously well-seen brainstem lesion disappeared on subsequent imaging. <h3>Background:</h3> MS diagnostic criteria require clinical symptoms combined with specific numbers and locations of MRI lesions. Supratentorial MRI lesions can have variable appearance and enhancement through disease course. Infratentorial lesions, although considered more specific, are often more challenging to assess as they can be mistaken for artifact on subsequent imaging. Here, we reviewed MRIs of a group of patients who had a brainstem lesion disappear on follow-up MRIs. <h3>Design/Methods:</h3> Patients identified as having disappearing infratentorial MRI lesions over the last 5 years were identified from our records and their images and clinical histories were reviewed. MRI’s were reviewed for lesion location, largest lesion diameter, the date of the lesion’s appearance and disappearance. <h3>Results:</h3> Twenty-four MS patients (F=16, M=8; Average disease duration at time of disappearance 11.6 years were identified to have had brainstem lesions disappear on subsequent scans. The average time from lesion’s first appearance to resolution was 2.70 years (SD 1.65) ranging from 9 months to 6 years. Six lesions were located in the medulla, 13 in the pons, 2 in the middle cerebellar peduncles, and 1 lesion in the midbrain. The average size of the lesions identified was 4.9 mm (SD=2.2), measured at the largest axial dimension. Eight of the lesions were highly active, showing significant enhancement on initial imaging. Difference in technique could not account for the apparent disappearance of these lesions. <h3>Conclusions:</h3> Brainstem lesions in MS patients can disappear on subsequent imaging. Disappearing MRI lesions may delay the diagnosis. These results suggest that more weight should be given to the reported clinical brainstem events, especially in the initial diagnosis of MS. <b>Disclosure:</b> Dr. Eckert has nothing to disclose. Dr. Weinstock-Guttman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Bianca Weinstock- Guttman received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&amp;Sanofi, Novartis and Acorda. Dr. Weinstock-Guttman has received research support from Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&amp;Sanofi, Novartis, Acorda. Dr. Kolb has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Channa Kolb has received speaker honoraria and consultant fees from EMD Serono, Teva Pharmaceuticals, Acorda, Novartis, Genzyme and Biogen-Idec. Dr. Hojnacki has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with David Hojnacki has received speaker honoraria and consultant fees from Biogen Idec, Teva Pharmaceutical Industries Ltd., EMD Serono, Pfizer Inc, and Novartis.