Comparative analysis of AQP4-IgG-positive and AQP4-IgG-negative NMOSD: A multicenter study in Latin America.
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Alonso Ricardo, Navas Carlos, Balbuena María Eugenia, Fernández Liguori Nora Aurora Rosa, Reyes Saúl, Gómez Figueroa Enrique, Carnero Contentti Edgar Carnero, Soto Ibis, Zarco Luis, Flores Rivera José de Jesús, Zuluaga Rodas María Isabel, Sánchez Rosales Nayeli A, Becker Jefferson, Treviño Frenk Irene, Ciampi Ethel, Correa Díaz Edgar Patricio, Gracia Fernando, Franco César, Restrepo-Aristizábal Carolina, Uribe-Vizcarra Valeria, Ramírez José Alejandro, Vintimilla Pesantez Santiago Andrés, García Acosta Jordi, Giraldo David, Mendoza de Salazar Sandra, González Cecilia, Márquez-Pedroza Jazmín, Toro Jaime, Noriega Juan Pablo, Guerrero-Udave Natali, Chaves Andrea, Sánchez Uribe Estefanía, Londoño Aristizábal Juan Pablo, Galleguillos Lorna
Аннотация
OBJECTIVE: To characterize the demographic and clinical features of NMOSD in Latin America, comparing AQP4-IgG-positive and AQP4-IgG-negative cases.
METHODS: A retrospective multicenter cohort study was conducted across Latin American NMOSD-specialized centers. Patients meeting the 2015-IPND diagnostic criteria were included.
RESULTS: Of the of 875 patients, 791 were included: 613 AQP4-IgG-positive and 178 AQP4-IgG-negative. AQP4-IgG-positive patients were more often female (87.4 % vs. 81.5 %, p = 0.05) and had a higher age at onset (41.4 vs. 38.0 years, p < 0.01). They more frequently presented with unilateral optic neuritis (30.1 % vs. 20.2 %, p < 0.01) and area postrema syndrome (9.3 % vs. 3.9 %, p < 0.01). Median EDSS at diagnosis was higher in the seronegative group (4.2 vs. 3.9, p < 0.01). Diagnostic delay was longer in this group as well, though not statistically significant. Older age at onset was the only independent predictor of AQP4-IgG positivity (OR = 1.02, p = 0.028).
CONCLUSIONS: AQP4-IgG-positive and seronegative NMOSD differ in clinical and demographic features, underscoring the need for tailored diagnostic and therapeutic approaches.