Инфекционные васкулиты в патогенезе демиелинизирующих заболеваний ЦНС у детей

Sixty-nine children with demyelinating diseases of CNS aged from 5 to 17 years were examined. Etiological diagnostics was performed using the polymerase chain reaction, immune cytochemistry and enzyme immunoassay techniques. The brain and spinal cord  magnetic resonance imaging (MRI) was performed, and desquamated circulating endotheliocytes and D-dimer levels in blood were  determined on the day of admission to the hospital, on the 30th day, in 3 and 6 months. Significantly higher desquamated circulating  endotheliocytes and D-dimer levels were established during the acute course of demyelinating diseases of the central nervous system  vs. the prolonged and especially chronic one. Pathogens were detected in 87% of patients: in the form of either mono (in 58%) or  mixed infections (in 42% of cases). It was found that if viruses are isolated in blood and/or cerebrospinal fluid after therapy in 3 and  6 months, the desquamated circulating endotheliocyte level remains elevated in patients, and with negative results, desquamated circulating endotheliocytes and D-dimer levels are normalized. The highest D-dimer values are observed in patients with hemorrhagic  inflammatory sites on MRI, and significantly higher mean values of desquamated circulating endotheliocytes are found in patients  with multiple contrasting foci on MRI scans. It is assumed that the main target in children with demyelinating CNS diseases are  cerebral venules, the lesion of which is interrelated with the course of the infectious process of herpes virus aetiology in 80% of cases.