E Carnero Contentti1, I Soto de Castillo2, V Daccach Marques3, P A López4, A Antunes Barreira3, E Armas2, C de Aquino Cruz3, A Rubstein5, C Lavigne Moreira3, O M Molina2, A Soto2, V Tkachuk6. 1. Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina. Electronic address: ecarnerocontentti@hospitalaleman.com. 2. Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela. 3. Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. 4. Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina. 5. Private office, Buenos Aires, Argentina. 6. Neuroimmunology Unit, Neurology Department, Hospital José de San Martin, Buenos Aires, Argentina.
Abstract
BACKGROUND: The 2015 International Panel for neuromyelitis optica (NMO) spectrum disorders (NMOSD) diagnosis (IPND) criteria was recently proposed. However, because there are no studies evaluating application of the IPND criteria in Latin American populations, we aimed to assess whether these new criteria improve the diagnostic rate and reduce the time taken to make the diagnosis in a cohort of Latin American patients. METHODS: We reviewed medical records and applied both the 2006 and 2015 diagnostic criteria to all patients seen in four centers in Argentina, Brazil and Venezuela. Patients with multiple sclerosis (MS, n = 915) or other well-established central nervous system (CNS) inflammatory diseases were excluded. AQP4-ab status was measured using indirect immunofluorescence (23%) and cell-based assay (CBA, 77%). In addition, data on gender, ethnicity, age and symptoms at onset, relapses, neuroimaging and immunosuppressive therapy were collected. RESULTS: A total of 104 patients were classified as presenting NMOSD (2015 IPND). Of these, 64 patients (61.5%) fulfilled the 2006 NMO criteria (32 AQP4-ab positive, 17 AQP4-ab negative and 15 unknown). Thus, 40 new patients (38.5%) were classified as presenting NMOSD using the 2015 IPND criteria (33 AQP4-ab positive, 5 AQP4-ab negative and 2 unknown AQP4-ab status), with a median time taken to fulfill the 2015 NMOSD criteria (n = 104) of 1 month (95% CI: 0.6-1.3) and a median time taken to fulfill the 2006 NMO criteria (n = 64) of 18 months (95% CI: 9-26) (log-rank test: p < 0.0001). Females, with median age of 37 years, white ethnicity and recurrent course, predominated in all samples. Ninety-nine patients (95.1%) had at least 1 of the 3 major core clinical characteristics, of which optic neuritis (56.7%) was the most frequent symptom at disease onset. CONCLUSION: This study showed that there was a 62.5% increase in the rate of diagnosing NMOSD through the 2015 IPND criteria, in comparison with the 2006 NMO criteria, with a shorter median time to diagnosis.
BACKGROUND: The 2015 International Panel for neuromyelitis optica (NMO) spectrum disorders (NMOSD) diagnosis (IPND) criteria was recently proposed. However, because there are no studies evaluating application of the IPND criteria in Latin American populations, we aimed to assess whether these new criteria improve the diagnostic rate and reduce the time taken to make the diagnosis in a cohort of Latin American patients. METHODS: We reviewed medical records and applied both the 2006 and 2015 diagnostic criteria to all patients seen in four centers in Argentina, Brazil and Venezuela. Patients with multiple sclerosis (MS, n = 915) or other well-established central nervous system (CNS) inflammatory diseases were excluded. AQP4-ab status was measured using indirect immunofluorescence (23%) and cell-based assay (CBA, 77%). In addition, data on gender, ethnicity, age and symptoms at onset, relapses, neuroimaging and immunosuppressive therapy were collected. RESULTS: A total of 104 patients were classified as presenting NMOSD (2015 IPND). Of these, 64 patients (61.5%) fulfilled the 2006 NMO criteria (32 AQP4-ab positive, 17 AQP4-ab negative and 15 unknown). Thus, 40 new patients (38.5%) were classified as presenting NMOSD using the 2015 IPND criteria (33 AQP4-ab positive, 5 AQP4-ab negative and 2 unknown AQP4-ab status), with a median time taken to fulfill the 2015 NMOSD criteria (n = 104) of 1 month (95% CI: 0.6-1.3) and a median time taken to fulfill the 2006 NMO criteria (n = 64) of 18 months (95% CI: 9-26) (log-rank test: p < 0.0001). Females, with median age of 37 years, white ethnicity and recurrent course, predominated in all samples. Ninety-nine patients (95.1%) had at least 1 of the 3 major core clinical characteristics, of which optic neuritis (56.7%) was the most frequent symptom at disease onset. CONCLUSION: This study showed that there was a 62.5% increase in the rate of diagnosing NMOSD through the 2015 IPND criteria, in comparison with the 2006 NMO criteria, with a shorter median time to diagnosis.
Authors: Yara Dadalti Fragoso; Heloisa Helena Ruocco; Ronaldo Maciel Dias; Hideraldo Cabeça; Ricardo Gonçalves; Nise A de Carvalho Sousa; Caroline Vieira Spessotto; Carlos Bernardo Tauil; Soniza Vieira Alves-Leon; Sidney Gomes; Marcus Vinicius M Gonçalves; Suzana C Nunes Machado; Andrea Anacleto; Eber Castro Correa; Maria Lucia V Pimentel; Gutemberg Augusto C Santos Journal: Neurol Ther Date: 2019-07-02
Authors: Fernando Gracia; Deyanira Ramírez; Alexander Parajeles-Vindas; Alejandro Díaz; Amado Díaz de la Fé; Nicia Eunice Ramírez Sánchez; Romy Castro Escobar; Luis Alberto García Valle; Roberto Weiser; Biany Santos; Awilda Candelario; Aron Benzadon; Pahola Araujo; Carlos Valderrama; Mario Larreategui; Gabriela Carrillo; Karla Gracia; Johana Vázquez-Céspedes; Priscilla Monterrey-Alvarez; Kenneth Carazo-Céspedes; Alfredo Sanabria-Castro; Gustavo Miranda-Loria; Andrea Balmaceda-Meza; Ligia Ibeth Portillo Rivera; Irma Olivera Leal; Luis Cesar Rodriguez Salinas; Arnold Thompson; Ericka López Torres; Daniel Enrique Pereira; Carolina Zepeda; César Abdón López; Ernesto Arturo Cornejo Valse; Karla Zinica Corea Urbina; Marco Antonio Urrutia; Ivonne Van Sijtveld; Blas Armien; Victor M Rivera Journal: Neurol Int Date: 2022-03-17