The impact of diagnostic criteria for neuromyelitis optica in patients with MS: a 10-year follow-up of the South Atlantic Project

Background: It is recognized that there is a particular geographic and ethnic distribution of neuromyelitis optica (NMO) among Caucasian and non-Caucasian populations. Objective: To review the diagnoses of patients whom were enrolled in the South Atlantic Project, a Brazilian multiple sclerosis (MS)...

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Published in:	Multiple sclerosis Vol. 20; no. 3; pp. 374 - 381
Main Authors:	Papais-Alvarenga, Regina M, Vasconcelos, Claudia CF, Alves-Leon, Soniza V, Batista, Elizabeth, Santos, Claudia MM, Camargo, Solange MGG, Godoy, Mauricio, Lacativa, Maria C, Lorenti, Mariangela, Damasceno, Benito, Damasceno, Alfredo, Brum, Doralina, Barreira, Amilton A, Guimarães Rocha, Maria S, Alvarenga, Helcio, Tilbery, Charles P
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-03-2014 Sage Publications Sage Publications Ltd
Subjects:	Adolescent Adult Biological and medical sciences Cerebrospinal fluid. Meninges. Spinal cord Child Cross-Sectional Studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Disease Progression Diseases of visual field, optic nerve, optic chiasma and optic tracts Female Follow-Up Studies Humans Male Medical sciences Middle Aged Multiple Sclerosis - complications Multiple Sclerosis - pathology Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Nervous system (semeiology, syndromes) Neurology Neuromyelitis Optica - diagnosis Neuromyelitis Optica - etiology Ophthalmology Young Adult encephalomyelitis Brasil epidemiology ethnicity inflammation demyelination multiple sclerosis primary progressive multiple sclerosis neuromyelitis optica relapsing–remitting multiple sclerosis Human Nervous system diseases Multiple sclerosis Optic nerve Encephalomyelitis South Neurooptic myelitis Inflammation Epidemiology Inflammatory disease Cerebral disorder relapsing-remitting multiple sclerosis Eye disease Cranial nerve disease Visual pathway Demyelination Central nervous system disease Degenerative disease Diagnosis Spinal cord disease
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Summary:	Background: It is recognized that there is a particular geographic and ethnic distribution of neuromyelitis optica (NMO) among Caucasian and non-Caucasian populations. Objective: To review the diagnoses of patients whom were enrolled in the South Atlantic Project, a Brazilian multiple sclerosis (MS) survey performed from 1995–1998, and to identify NMO and MS case frequencies. Methods: We reviewed the data from a 10-year follow-up of MS patients. To apply the current diagnostic criteria, the neurologists were asked to collect clinical and laboratory data from the medical records of study patients treated from 1999–2009. Results: The spectrum of inflammatory demyelinating disease in 322 patients (67% white; 33% African-Brazilian) was: 49 (15%) with NMO; 14 (4%) with NMO syndromes; 10 (3%) with acute disseminated encephalomyelitis (ADEM); one isolated tumefactive brain lesion; 249 (77%) with MS (151 with relapsing–remitting MS (RRMS), 70 with secondary progressive MS (SPMS) and 27 with primary progressive MS (PPMS)). Disability was more severe in NMO and PPMS. One-third of the NMO patients had died. Conclusions: The frequency of NMO was 6.8% in São Paulo and 20.5% in Rio de Janeiro, and mainly seen in persons of African descent, which strengthens the hypothesis of there being an ethnic association of this disease. We recommend that epidemiological studies on MS that were performed previously be reviewed again, to ensure more accurate diagnoses.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1352-4585 1477-0970
DOI:	10.1177/1352458513495580