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Multiple Sclerosis Journal

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Institución detectada Período Navegá Descargá Solicitá
No detectada desde feb. 1999 / hasta dic. 2023 SAGE Journals

Información

Tipo de recurso:

revistas

ISSN impreso

1352-4585

ISSN electrónico

1477-0970

Editor responsable

SAGE Publishing (SAGE)

País de edición

Estados Unidos

Fecha de publicación

Cobertura temática

Tabla de contenidos

Incidence and prevalence of neuromyelitis optica spectrum disorder in a contemporary, multi-ethnic cohort

Angus Lee; Radostina T Iordanova; Jessica B Smith; Bonnie H Li; Kathryn B Schwarzmann; Samir Alsalek; Talar S Habeshian; Sakar Budhathoki; Viridiana Hernandez-Lopez; Fernando Torres; Annette M Langer-GouldORCID

<jats:sec> <jats:title>Background:</jats:title> <jats:p>Ecological comparisons suggest that neuromyelitis optic spectrum disorder (NMOSD) is more common in African Caribbean and Asian compared to White people.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective:</jats:title> <jats:p>The aim is to rigorously assess susceptibility across multiple racial and ethnic groups from the same cohort.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We conducted a retrospective cohort study of &gt; 39 million person-years of observation from members of Kaiser Permanente Southern California. The electronic health records of individuals with at least one International Classification of Diseases (ICD) code for NMOSD were reviewed to identify persons who met 2015 diagnostic criteria for NMOSD.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>We identified 153 NMOSD cases, 105 incident and 105 prevalent. The age- and sex-standardized incidence (2013–2022) and prevalence (2019) according to the 2020 US Census per 100,000 person-years was significantly higher in Black persons (incidence = 0.90, 95% confidence interval (CI) = 0.59–1.21; prevalence = 8.44, 95% CI = 5.52–11.36) compared to all other racial and ethnic groups. The incidence was similar among Asian/Pacific Islander (0.32, 95% CI = 0.16–0.48) compared to Hispanic people (0.19, 95% CI = 0.13–0.25) and lowest in White people (incidence = 0.13, 95% CI = 0.07–0.19).</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion:</jats:title> <jats:p>NMOSD susceptibility is highest in Black people, followed by Asian/Pacific Islands, then Hispanic people, and lowest in White people. Studies in diverse groups of minoritized people are needed to determine whether this increased susceptibility is due to shared genetic ancestry, the ill-health consequences of racism, or both.</jats:p> </jats:sec>

Pp. No disponible

Uncovering alternative diagnoses in patients with clinical syndromes suggestive of multiple sclerosis: A transversal study from the prospective Barcelona CIS cohort

Andreu VilasecaORCID; Mar TintoréORCID; Pere Carbonell-Mirabent; Marta Rodríguez-Barranco; Mª Jesús ArévaloORCID; Helena Ariño; Cristina Auger; Luca Bollo; René Carvajal; Joaquín Castilló; Alvaro Cobo-CalvoORCID; Manuel ComabellaORCID; Victoria Fernández; Ingrid Galan; Luciana Midaglia; Neus Mongay-Ochoa; Carlos Nos; Susana Otero-Romero; Agustín PappollaORCID; Jordi RioORCID; Breogan Rodriguez-AcevedoORCID; Jaume Sastre-GarrigaORCID; Sofía Sceppacuercia; Paula TaglianiORCID; Carmen TurORCID; Angela Vidal-JordanaORCID; Javier Villacieros-Álvarez; Ana ZabalzaORCID; Àlex RoviraORCID; Xavier Montalban; Georgina ArrambideORCID

<jats:sec> <jats:title>Background:</jats:title> <jats:p>It is essential to exclude alternative diagnoses to diagnose multiple sclerosis (MS). However, detailed descriptions of alternative diagnoses in patients with suspected MS presenting with clinically isolated syndrome (CIS) are limited.</jats:p> </jats:sec> <jats:sec> <jats:title>Objectives:</jats:title> <jats:p>To describe alternative diagnoses in patients presenting with CIS suggestive of MS.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We conducted a descriptive analysis of patients from the Barcelona CIS cohort including subjects under 50 years of age with a CIS suggestive of MS but later diagnosed with conditions other than MS. We collected clinical, biological, and radiological data, and described the alternative etiologies identified.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Among 1468 patients in the Barcelona CIS cohort, 100 (6.8%) were diagnosed with an alternative condition. The most common neurological syndrome was optic neuritis (43.0%). Four patients (4.0%) had inflammatory-demyelinating lesions in at least two typical MS topographies on baseline magnetic resonance imaging (MRI), and 2 (2.0%) met the 2017 McDonald MS criteria. The most common etiologies were immune-mediated diseases (42.0%), especially MOGAD, followed by functional neurological disorders (15.0%) and vascular disease (10.0%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>The range of alternative diagnoses encountered during the MS diagnostic process highlights the need to rule out better explanations than MS. However, current MS diagnostic criteria effectively identify patients without MS in this context.</jats:p> </jats:sec>

Pp. 408-417