New MDS criteriaの注目点—病理学の観点から

New MDS Criteria for the Diagnosis of Multiple System Atrophy: A Clinicopathological Viewpoint

多系統萎縮症（multiple system atrophy：MSA）の臨床診断基準が2008年に発表されて以来，いくつかの改善すべき点が明らかとなった。つまり，MSAと臨床診断された患者にはパーキンソン病や進行性核上性麻痺など他の病態（MSA look-alike）が混入している可能性があること，MSAの治療にはMSAを病早期に高い精度で診断する必要性があること，などである。本論では，今回改訂された新臨床診断基準を臨床病理学的な立場から解説する。

Abstract

Since its publication in 2008, several operational issues have emerged in the second consensus diagnostic criteria for multiple system atrophy (MSA). In fact, a small proportion of patients with other conditions, including Parkinson's disease or progressive supranuclear palsy, may be misdiagnosed as having MSA over the course of their life. In addition, it is necessary to identify patients with MSA with high accuracy, especially in the early stage of disease, to allow treatment. With the second consensus diagnostic criteria, however, the disease often reaches an advanced stage by the time of diagnosis. In this review, we focus on key modifications in the third consensus diagnostic criteria for MSA from a clinicopathological point of view.