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The third course of multiple sclerosis treatment in patient D.C.

We had honour to accept at EmCell clinic Mr. D.C., DOB November 3, 1959. This is the third visit of Mr. D.C. to the clinic ). Previous courses of cell therapy (the first, the second) stopped progress of disease and gave certain amelioration of the state as noted below.

We have established the following diagnosis: Multiple sclerosis of cerebrospinal type with tetraparesis mostly expressed in legs, d>s. Concomitant divergent strabismus OS. Middle range nystagmus. Hypermetropic astigmatism. Angiopathy of retina. Initial maculodystrophy of both eyes.

Tests:

Average blood count: Erythrocytes 4.4x1012/l, Hb 146 g/l. color index 1.0, thrombocytes 190x109/l, leukocytes 5.2x109/l, stebcellsstab neutrophils 3%, segmented neutrophils 65%, eosinophiles 2%, lymphocytes 22%, monocytes 8%, ESR 3 mm/hr.

Blood glucose: 4.3 mmol/l.

Blood Chemistry: Bilirubin total 15.1 mmol/l, direct - neg., indirect 15.1 mmol/l, ALT 0.38 mmol/l, ACT 0.21 mmol/l, thymol test 2.4 units, urea 6.9 mmol/l, creatinine 0.074 mmol/l.

Common urine analysis: Volume 120.0 ml, density 1020, transparent, light-yellow, protein - neg., sugar - neg., flat epithelium in small quantity, leukocytes - single in the field of vision.

ECG: Regular sinus rhythm. Normal position of the heart axis. Signs of dystrophic changes in myocardium.

Neurological Examination.

The patient is admitted to the clinic third time the first, the second). The patient notes substantial improving of his condition: he stands up by himself, stays, periodically - walks with the help of a stick. Considerably improved the sight and hearing for the left ear. Diplopy passed away, there appeared possibility of visual load, including work with a computer. Last period the patient can be served by himself (meal, dressing, toilet, etc.).

Neurological status: Patient is in contact, adequate, oriented. Eye slots and pupils d=s, the movements of eye apples in full range, convergation satisfactory, periodically horizontal middle range exhaustion nystagmus. The face is symmetric. Tongue in the middle line. The range of active movements in arms is not limited. Tonus in arms is practically unchanged. Reflexes are enhanced, d>s, with enlargement of reflex zones. Strength in the legs diminished d>s, in distal parts more. Tonus in legs is increased substantially, more in flexors, more in the left leg. In the right leg tonus is combined due to "cerebellum" hypotony. Reflexes are high, without enlargement of reflex zones, clonus in feet is absent. Left plantar reflex. On the right side unconvincing Babinski’s sign. The pain sensitivity is intact, test for coordination executes sufficiently. Stays leaning upon the stick.

Conclusion: multiple sclerosis of cerebrospinal type with tetraparesis, d>s, mostly in legs, deterioration of walking.

Recommendation: to continue cell therapy.

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 about 10 grad. according Girshberg. Horizontal medium range nystagmus at the side look. Pupils reaction for the light is vivid. Optical media transparent. In the of nervi opticinervifundus of the eyes: discs opticiof optical nerves are shaped of pallid pink color. Arteries are narrow. Arteries/venues = 1/3. 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.

Cell therapy:


The 1st day. Transplantation of the sample 3038P513 drop-wise intravenously in amount of 2.0 ml; implantation of the sample 3038PM513 subcutaneously in the frontal abdomen in two depots in amount of 1.1 ml each.

The 2nd day. Transplantation of the sample 3038P513 drop-wise intravenously in amount of 1.6 ml; implantation of the sample 3038PM513 subcutaneously in the frontal abdomen in two depots in amount of 1.0 ml each.

The 3rd day. Transplantation of the sample 3038P134 drop-wise intravenously in amount of 2.1 ml; implantation of the sample 3038PM134 subcutaneously in the frontal abdomen in two depots in amount of 0.6 ml each.

The 4th day. Implantation of the sample 3038PM134 subcutaneously in the frontal abdomen in two depots in amount of 1.0 ml each.

The cell suspension samples 3038P513, 3038PM513, 3038P134 and 3038PM134 possessed the functional activity as mentioned above and are certified as follows:

Bacterial sterility test Negative
Prenatal diagnostic
Test with cardiolipid antigen Negative
Anti-HIV1/HIV2 Negative
HBsAg Negative
Fetal diagnostic
Enzygnost Anti-HIV1/HIV2 Negative
HBsAg monoclonal Negative
Anti-HBc monoclonal Negative
Anti-CMV/IgG+IgM Negative
Anti-Rubella Virus/IgG Negative
Varicella/Zoster Negative
Toxoplasmosis/IgG Negative

The treatment was tolerated well with no side effects.

The condition of the patient was improved: it was noted syndrome of early posttransplantation amelioration in a form of increasing of mental working capacity, improving of mood. Long term effects of the treatment are clear from neurologist description. It is time to train legs in the vertical position.

Mr. D.C. is recommended:

1. To continue cell therapy in EmCell clinic in 9–12 months.
2. To use mechanotherapy for improving of movements, to make training in vertical position, including training in a swimming pool.
3. To try Sirdalud (Tizanidin), Sandoz, 0.002 1/2 of the tablet to control and diminish remove hypertonia first at repose in sitting pose, then at the movements of legs.

Fetal stem cells treatment results depend on: disease's severity, age of the patient, adherence for the medications and regime. Treatment results, presented on this site, are individual for each clinical case.