Validation of the 2015 diagnostic criteria for neuromyelitis optica spectrum disorders in a cohort of South Indian patients.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 16 05 2019
revised: 16 07 2019
accepted: 27 07 2019
pubmed: 6 8 2019
medline: 4 4 2020
entrez: 6 8 2019
Statut: ppublish

Résumé

Neuromyelitis Optica spectrum disorders (NMOSD) are one of the most common CNS demyelinating disorders as they will present with disabling recurrent demyelinating attacks. Hence, it is of paramount importance to diagnose early, and early diagnoses and intervention will prevent further relapses associated with NMOSD. New international consensus criteria have been proposed and studies validating its application towards diagnoses of NMOSD in south Asian population are meagre. Hence we validated the proposed International Panel for NMO Diagnosis (IPND), 2015 criteria to study the clinical, demographic profile and sero-status of patients who are presenting with core clinical symptoms of NMOSD in South India and compare it with 2006 criteria. A retrospective study was conducted in a tertiary hospital for a period of one year. Patients who had at least one core clinical feature of NMOSD were included. Demographics and clinical data were recorded and analysed. Cases were evaluated using 2015 IPND and 2006 criteria for all patients, data was analysed using SPSS. A total of 110 patients were included and 91(82.72%) patients fulfilled IPND 2015 criteria. Out of 91 patients, 70 patients were AQP4 antibody positive and 21 were negative. Out of 110, only 30 (27.2%) satisfied 2006 criteria (24 or 80% were seropositive). 2015 criteria were more sensitive in identifying 61 new NMOSD cases juxtaposed to 2006 criteria, this difference was statistically significant (P<0.05). The 2015 IPND criteria were more sensitive and specific than previous 2006 criteria as it covered diverse clinical manifestations of NMOSD. Applying this criteria, NMOSD could be diagnosed among patients with monophasic illness, isolated recurrent optic neuritis, isolated recurrent myelitis, cerebral syndrome, diencephalic syndrome, brainstem syndrome and area postrema syndrome, thus improving the diagnostic yield.

Sections du résumé

BACKGROUND BACKGROUND
Neuromyelitis Optica spectrum disorders (NMOSD) are one of the most common CNS demyelinating disorders as they will present with disabling recurrent demyelinating attacks. Hence, it is of paramount importance to diagnose early, and early diagnoses and intervention will prevent further relapses associated with NMOSD. New international consensus criteria have been proposed and studies validating its application towards diagnoses of NMOSD in south Asian population are meagre. Hence we validated the proposed International Panel for NMO Diagnosis (IPND), 2015 criteria to study the clinical, demographic profile and sero-status of patients who are presenting with core clinical symptoms of NMOSD in South India and compare it with 2006 criteria.
METHODS METHODS
A retrospective study was conducted in a tertiary hospital for a period of one year. Patients who had at least one core clinical feature of NMOSD were included. Demographics and clinical data were recorded and analysed. Cases were evaluated using 2015 IPND and 2006 criteria for all patients, data was analysed using SPSS.
RESULTS RESULTS
A total of 110 patients were included and 91(82.72%) patients fulfilled IPND 2015 criteria. Out of 91 patients, 70 patients were AQP4 antibody positive and 21 were negative. Out of 110, only 30 (27.2%) satisfied 2006 criteria (24 or 80% were seropositive). 2015 criteria were more sensitive in identifying 61 new NMOSD cases juxtaposed to 2006 criteria, this difference was statistically significant (P<0.05).
CONCLUSION CONCLUSIONS
The 2015 IPND criteria were more sensitive and specific than previous 2006 criteria as it covered diverse clinical manifestations of NMOSD. Applying this criteria, NMOSD could be diagnosed among patients with monophasic illness, isolated recurrent optic neuritis, isolated recurrent myelitis, cerebral syndrome, diencephalic syndrome, brainstem syndrome and area postrema syndrome, thus improving the diagnostic yield.

Identifiants

pubmed: 31382202
pii: S2211-0348(19)30317-7
doi: 10.1016/j.msard.2019.07.024
pii:
doi:

Substances chimiques

Aquaporin 4 0
Autoantibodies 0
Immunoglobulin G 0

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

164-169

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Meena A Kanikannan (MA)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India. Electronic address: meenaak@hotmail.com.

Praveen Kumar Arepareddy (PK)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Neeharika L Mathukumalli (NL)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Sireesha Y (S)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Rukmini Mridula Kandadai (RM)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Afshan S Jabeen (AS)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Suryaprabha T (S)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

Rupam Borgohain (R)

Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.

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