Multiple sclerosis of cerebrospinal type with tetraparesis, d>s, mostly in the legs. Concomitant divergent strabismus. Middle range nystagmus. Hypermetropic astigmatism. Angiopathy of retina. Initial maculodystrophy of both eyes.

We had the honour to accept at our Cell Therapy Clinic of National Medical University and Center 'EmCell' Mr. D.C., DOB November 3, 1959. Mr. D.C. stayed at Cell Therapy Clinic from 6 to 11 of October, 1996. Mr. D.C.. was attended by Mrs. Ingrid Il.

We established the following diagnosis:

Multiple sclerosis of cerebrospinal type with tetraparesis, d>s, mostly in the legs. Concomitant divergent strabismus. Middle range nystagmus. Hypermetropic astigmatism. Angiopathy of retina. Initial maculodystrophy of both eyes.

Tests:

7.10.96 Average blood count:

Erythrocytes - 4,95*10¹²/l, Hb 160 g/l, color index 1.0, thrombocytes 260*10⁹/l, leukocytes 7.4*10⁹/l, stab neutrophils 3%, segmented neutrophils 68%, eosinophiles 1%, lymphocytes 26%, monocytes 2%, ESR 3 mm/hr.

8.10.96 Average blood count:

Erythrocytes - 4,8*10¹²/l, Hb 160 g/l, color index 1.0, thrombocytes 190*10⁹/l, leukocytes - 5.6*10⁹/l, stab neutrophils 4%, segmented neutrophils 69%, eosinophiles 3%, lymphocytes 21%, monocytes 3%, ESR 2 mm/hr.

10.10.96 Average blood count:

Erythrocytes - 4,0*10¹²/l, Hb 130 g/l, color index 0.9, thrombocytes 600*10⁹/l, leukocytes - 5.0*10⁹/l, stab neutrophils 8%, segmented neutrophils 65%, eosinophiles 3%, lymphocytes 21%, monocytes 3%, ESR 16 mm/hr.

8.10.96 Blood chemistry:

Bilirubin total 17.6 mmol/l, direct - neg., indirect 17.6 mmol/l, ALT 0.32 mmol/l, ACT 0.21 mmol/l, thymol test 4.3 units, cholesterol 5.4. mmol/l, urea 6.2 mmol/l, creatinine 0.065 mmol/l.

7.10.96 Blood glucose 4.6 mmol/l.

11.10.96 Blood glucose 3.3 mmol/l.

7.10.96 Common urine analysis:

Volume 180.0 ml, density 1018, transparent, light-yellow, protein - neg., sugar - neg., flat epithelium in small quantity, leukocytes 2-3 in the field of vision, mucus in small quantity, small amount of oxalates.

10.10.96 Common urine analysis:

Volume 70.0 ml, density 1018, transparent, light-yellow, protein - neg., sugar - neg., flat epithelium in small quantity, leukocytes 2-3 in the field of vision, mucus in small quantity, small amount of oxalates.

7.10.96 ECG:

Regular sinus rhythm, normal position of heart axis, dystrophic changes in myocardium.

16.10.96 ECG:

Regular sinus rhythm, diffuse changes of myocardium.

12.10.96 Examination by neurologist.

The patient fell ill 4 years ago. He complaints of the inability to walk - the legs are heavy, constrained, he can stay only with the extrinsic aid due to ataxia and weakness of legs. Complaints on the disorders of sight - convergence is difficult, double vision (left eye flows aside at fixation). In neurological status is in contact, oriented. Divergent strabismus due to the left eye. Pupils d=s, photo reactions are torpid. Horizontal middle range nystagmus by the side look, s=d. The face is symmetric. Pharynx reflex is intact. The range of active movements in legs and arms is limited. Tonus in arms is increased insignificantly, in the legs -manifest spastic, reflexes enhanced, d>s, clonus in feet d>s, in both sides "fan" symptom. The pain sensitivity is intact, test for coordination executes sufficiently. According the results of MRI of cerebrum - multiple loci of lesion in truncus cerebry, corpus callosum. Conclusion: multiple sclerosis of cerebrospinal type with tetraparesis, d>s, mostly in legs, deterioration of vision.

11.10.96. Examination by ophthalmologist.

At the approximate test of vision with the glasses >0.6. Refraction: Hypermetropic astigmatism. Movement of eyes in full range. Divergent strabismus 10-15 grad. by Girshberg. Horizontalnystagmus of medium range nystagmus at the side look. Pupils reaction for the light is vivid. The anterior part of eyes without pathology. Optical media transparent. In the bottom of the eyes: disci of optical nerves are shaped of pallid pink color. Arteries are narrow. Arteries/veins = 1/3. Veins are meandered. Solitary loci of dystrophy in the macular and central zones of the retina. Conclusion: Concomitant divergent strabismus. Middle range nystagmus. Hypermetropic astigmatism. Angiopathy of retina. Initial maculodystrophy of both eyes.

Mr. D.C. received a course of Cell Therapy. The action of cell suspensions was directed to the restitution of nerve connections and normalization of hemato-encephalic barrier functions.

6.10.96 Implantation of the Cell suspension sample 3038 AM 118 subcutaneously in the frontal abdomen in two depots in amount 1.0 ml each.

7.10.96 Transplantation of the Cell suspension sample 3038 A 118, IV, amount 2.0 ml. Implantation of the Cell suspension sample 3038 AM 118 subcutaneously in the frontal abdomen in two depots in amount 1.0 ml each.

9.10.96 Transplantation of the Cell suspension sample 3038 A 118, IV, amount 2.5 ml. Implantation of the Cell suspension sample 3038 AM 118 subcutaneously in the frontal abdomen in two depots in amount 0.7 ml each.

10.10.96 Transplantation of the Cell suspension sample 3038 A 118, IV, amount 2.2 ml.

11.10.96 Transplantation of the Cell suspension sample 3038 A 228, IV, amount 3.2 ml. Implantation of the Cell suspension sample 3038 AM 228 subcutaneously in the frontal abdomen in two depots in amount 1.4 ml each.

The Cell suspension samples 3038 AM 118, 3038 A 118, 3038 AM 228 and 3038 A 228 possess the mentioned above functional activity and are certified as follow:

The state of the patient improved: diminished the weakness in arms and legs, decreased the hypertonia of neck muscles, muscles of the back, arms, and legs. Divergence of eyes decreased. Syndrome of early post transplantation improvement of general condition was observed. It gave the effect of immediate (the night after first transplantation) enhancement of the range of movement. The patient noted, that he had stand up several times without external help and could walk by himself around the ward. There were observed normalization of the sleep formula, increasing of appetite, work capacity, improvement of mood.

Recommendations:

Taking into consideration apparent progress of the condition of Mr. D.C. we recommend to continue the course of Cell Therapy. The reservation for the next visit to our Cell Therapy Clinic is made for December 2-9, 1996.

Head of the Cell Therapy Clinic
of National Medical University and Center "EmCell"
professor Alexander Smikodoub.