Is Asian type MS an MS phenotype, an NMO spectrum disorder, or a MOG-IgG related disease?

Autor: Papais Alvarenga RM; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Hospital Federal da Lagoa, Rio de Janeiro, Brazil. Electronic address: regina_alvarenga@hotmail.com., Araújo ACRAE; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Hospital Federal da Lagoa, Rio de Janeiro, Brazil. Electronic address: anacarolinaraa@hotmail.com., Nascimento ACB; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: annachrisbrandao@outlook.com., Araujo NEC; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: nadjadearaujo@hotmail.com., Meneguette NS; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: nathi_meneguette@hotmail.com., Neri VC; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Hospital Federal da Lagoa, Rio de Janeiro, Brazil. Electronic address: vandersoncn@yahoo.com.br., Papais Alvarenga M; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: alvarenga_marina@hotmail.com., Filho HA; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: Profhelcioalvarenga@gmail.com., Barros PO; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: pri.obarros@gmail.com., Bento CA; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: cbento@globo.com., Schmidt SL; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: slschmidt@terra.com.br., Vasconcelos CCF; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: cfvas@hotmail.com., Alvarenga MP; Serviço de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Hospital Federal da Lagoa, Rio de Janeiro, Brazil. Electronic address: marcos_alvarenga@hotmail.com.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2020 Jul; Vol. 42, pp. 102082. Date of Electronic Publication: 2020 Apr 13.
DOI: 10.1016/j.msard.2020.102082
Abstrakt: Background: A specific particularity of neurological diseases in Asia is the relative commonality of neuromyelitis optica (NMO) and Asian type MS (OSMS). Both conditions also occur in South American patients. The Brazilian population differs from the European and the Asian populations due to the mixture of ancestralities between European colonizers and African slaves. To better know the clinical characteristics of Brazilian patients with Asian type MS this study aimed to analyze the clinical, radiological and serological data that would help to distinguish between OSMS and NMO and clarify, in a Non-Asian population, if OSMS is an MS phenotype, an NMO spectrum disorder by 2015 classification, or a complement activating antibody to myelin oligodendrocyte glycoprotein (MOG-IgG) antibody-related disease.
Methods: We selected cases retrospectively with NMO and OSMS in the medical registry of patients with idiopathic inflammatory demyelinating diseases under follow-up since 1997 in Federal Hospital da Lagoa, the principal reference center for MS treatment in Rio de Janeiro, Brazil. OSMS has selective involvement of the optic nerve and spinal cord with no cerebral or cerebellar symptoms associated with small spinal cord lesions and negativity for the aquaporin-4 antibody (AQP4-IgG). NMO full-filled the revised criteria (2006) associated with longitudinally extensive transverse myelitis (LETM). We recorded the following data: ethnicity/skin color, neurologic impairment "at nadir" and "at recovery" of the index events (optic neuritis and transverse myelitis), long term disability, mortality, health quality of life scores by the SF-36 questionnaire, CSF IgG oligoclonal bands and serological AQP4-IgG and MOG-IgG antibodies tested by Cell-based assay. The last brain MRIs were classified as either satisfying or not satisfying MAGNIMS radiologic criteria for MS or typical or not typical for NMOSD. The new classification of NMO spectrum disorders (2015) was applied.
Results: Forty-one OSMS and 122 NMO cases were analyzed. OSMS affected mainly young white women, causing unilateral optic neuritis and partial myelitis with excellent recovery. After a mean disease duration of 20 years, 90% of the patients had free ambulation, and 70% had a mild disability or no disability. Only 7.2% presented a secondary progressive course, and no deaths occurred. All cases had negativity to AQP4-IgG and MOG-IgG biomarkers. 95% had resonance criteria for MS. OSMS differed from NMO by ethnicity, morbidity, and mortality: most were African descendants, with severe motor and visual dysfunction, and one third died. Only NMO cases full-filled the new NMOSD classification (52 AQP4-IgG positive, 29 AQP4-IgG negative, and 41 AQP4-IgG unknown).
Conclusion: In Brazilian patients, OSMS and NMO are different immune-mediated diseases. OSMS is a milder MS phenotype.
Competing Interests: Declaration of Competing Interest The authors have any conflict of interest with the subject of the study.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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