Multiple sclerosis 2017 McDonald criteria are also relevant for Tunisians.


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:
Aug 2020
Historique:
received: 22 07 2019
revised: 24 12 2019
accepted: 26 04 2020
pubmed: 14 6 2020
medline: 11 5 2021
entrez: 14 6 2020
Statut: ppublish

Résumé

Validation of the 2017 revised McDonald criteria was based on data from Caucasians. Among North Africans, Multiple Sclerosis prevalence, clinical phenotype and differential diagnosis are different. Hence, verifying the relevance of the latest revised criteria applied in North Africans was recommended. The aim of our study was to investigate the applicability and reliability of the revised 2017 McDonald criteria, compared to the 2010 version, with the relevance to the diagnosis of Multiple sclerosis in a Tunisian cohort. Data from patients, with a typical clinically isolated syndrome, were re-analyzed retrospectively. Also, clinical, immunological and imaging characteristics were reviewed, according to the 2010, then 2017, McDonald criteria. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were evaluated to analyze the impact of the new criteria in everyday clinical practice. A total of 98 patients were included. Eighty-eight patients developed a definite Multiple Sclerosis, while ten had a different diagnosis. With relevance to the 2010 criteria, 41 patients (42%) were diagnosed with Multiple Sclerosis, after the first clinical attack. The 2017 revised criteria allowed to diagnose 32 more cases (73 patients = 74%). Sensitivity of the 2017 criteria was higher (77% versus 44%), but specificity was lower (33% versus 63%). Compared to the 2010 version, the 2017 McDonald criteria highlighted higher sensitivity, but lower specificity for Tunisians.

Sections du résumé

BACKGROUND BACKGROUND
Validation of the 2017 revised McDonald criteria was based on data from Caucasians. Among North Africans, Multiple Sclerosis prevalence, clinical phenotype and differential diagnosis are different. Hence, verifying the relevance of the latest revised criteria applied in North Africans was recommended. The aim of our study was to investigate the applicability and reliability of the revised 2017 McDonald criteria, compared to the 2010 version, with the relevance to the diagnosis of Multiple sclerosis in a Tunisian cohort.
METHODS METHODS
Data from patients, with a typical clinically isolated syndrome, were re-analyzed retrospectively. Also, clinical, immunological and imaging characteristics were reviewed, according to the 2010, then 2017, McDonald criteria. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were evaluated to analyze the impact of the new criteria in everyday clinical practice.
RESULTS RESULTS
A total of 98 patients were included. Eighty-eight patients developed a definite Multiple Sclerosis, while ten had a different diagnosis. With relevance to the 2010 criteria, 41 patients (42%) were diagnosed with Multiple Sclerosis, after the first clinical attack. The 2017 revised criteria allowed to diagnose 32 more cases (73 patients = 74%). Sensitivity of the 2017 criteria was higher (77% versus 44%), but specificity was lower (33% versus 63%).
CONCLUSIONS CONCLUSIONS
Compared to the 2010 version, the 2017 McDonald criteria highlighted higher sensitivity, but lower specificity for Tunisians.

Identifiants

pubmed: 32534445
pii: S2211-0348(20)30237-6
doi: 10.1016/j.msard.2020.102161
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102161

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

A Souissi (A)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

S Mrabet (S)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

A Nasri (A)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

F Larnaout (F)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

M Bendjebara (M)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

A Gargouri (A)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

I Kacem (I)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health.

R Gouider (R)

Department of Neurology, Razi Hospital, LR 18SP03, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia; Clinical Investigation Center Neurosciences and Mental Health. Electronic address: riadh.gouider@gnet.tn.

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