Late Onset of Neuromyelitis Optica Spectrum Disorders

Autor: 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
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Neurology and Therapy, Vol 8, Iss 2, Pp 477-482 (2019)
Druh dokumentu: article
ISSN: 2193-8253
2193-6536
DOI: 10.1007/s40120-019-0143-2
Popis: Abstract Introduction Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system. NMOSD starting after the age of 50 years is considered a “late onset” (LO-NMOSD) and seems to be particularly aggressive. The objective of this paper is to present a series of 37 Brazilian patients with LO-NMOSD. Methods Retrospective data collection from medical records of patients with LO-NMOSD seen at 14 Brazilian specialized units. Results The ratio of women to men in the sample was 4.3 to 1. The patients were followed up for a median period of 4 years. Sex, age at disease onset, and ethnic background were not associated with the number of relapses or disability outcomes. Extensive longitudinal myelitis affected 86% of patients, while optic neuritis affected 70%, and brainstem syndromes were present in only 16% of these patients. Six patients are currently using some type of support for walking or are wheelchair-bound. Three have died. Therapeutic options for NMOSD were particularly complicated for these elderly patients, since medications for controlling NMOSD are, in essence, immunosuppressive. Long-term use of corticosteroids can be an issue when the patients have high blood pressure, diabetes mellitus, or dyslipidemia (conditions often seen in elderly individuals). Conclusion This series of LO-NMOSD cases highlights the importance of prompt diagnosis and treatment for these patients.
Databáze: Directory of Open Access Journals
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