The first course of multiple sclerosis treatment in patient D.C.
We had the honour to accept at EmCell clinic Mr. D.C., DOB November 3, 1959, attended by Mrs. I.
: 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.
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.
. Implantation of the cell suspension sample 3038AM118 subcutaneously in the frontal abdomen in two depots in amount 1.0 ml each.
. Transplantation of the cell suspension sample 3038A118, IV, amount 2.0 ml. Implantation of the cell suspension sample 3038AM118 subcutaneously in the frontal abdomen in two depots in amount 1.0 ml each.
. Transplantation of the cell suspension sample 3038A118, IV, amount 2.5 ml. Implantation of the cell suspension sample 3038AM118 subcutaneously in the frontal abdomen in two depots in amount 0.7 ml each.
. Transplantation of the cell suspension sample 3038A118, IV, amount 2.2 ml.
. Transplantation of the cell suspension sample 3038A228, IV, amount 3.2 ml. Implantation of the cell suspension sample 3038AM228 subcutaneously in the frontal abdomen in two depots in amount 1.4 ml each.
The cell suspension samples 3038AM118, 3038A118, 3038AM228 and 3038A228 possess the mentioned above functional activity and are certified as follows:
| Bacterial sterility test
| Prenatal diagnostic
| Test with cardiolipid antigen
| Anti - HIV1/HIV2
| Fetal diagnostic
| Enzygnost Anti - HIV1/HIV2
| HBsAg monoclonal
| Anti - HBc monoclonal
| Anti - CMV/IgG+IgM
| Anti - Rubella Virus/IgG
Average blood count:
/l, Hb 160 g/l, color index 1.0, thrombocytes 260x109
/l, leukocytes 7.4x109
/l, stab neutrophils 3%, segmented neutrophils 68%, eosinophiles 1%, lymphocytes 26%, monocytes 2%, ESR 3 mm/hr.
: 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.
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.
ECG on the 1st day of treatment:
Regular sinus rhythm, normal position of heart axis, dystrophic changes in myocardium.
ECG on the 5th day of treatment:
Regular sinus rhythm, diffuse changes of myocardium.
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.
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.
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.
Taking into consideration apparent progress of the condition of Mr. D.C. we recommend continuing the course of cell therapy in 6–8 months.