Neurology and therapy · 2019
Late Onset of Neuromyelitis Optica Spectrum Disorders.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Fragoso Yara Dadalti, Ruocco Heloisa Helena, Dias Ronaldo Maciel, Cabeça Hideraldo, Gonçalves Ricardo, de Carvalho Sousa Nise A, Spessotto Caroline Vieira, Tauil Carlos Bernardo, Alves-Leon Soniza Vieira, Gomes Sidney, Gonçalves Marcus Vinicius M, Machado Suzana C Nunes, Anacleto Andrea, Correa Eber Castro, Pimentel Maria Lucia V, Santos Gutemberg Augusto C
Аннотация
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.
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.