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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(S 01): S1-S52
DOI: 10.1055/s-0044-1789369
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Exploring very late-onset NMOSD: frequency and clinical features in Latin America

Marco A. Lana-Peixoto
1   Universidade Federal de Minas Gerais, Faculdade de Medicina, Centro de Investigação de Esclerose Múltipla (CIEM), Belo Horizonte MG, Brazil.
,
Natália Cirino Talim
1   Universidade Federal de Minas Gerais, Faculdade de Medicina, Centro de Investigação de Esclerose Múltipla (CIEM), Belo Horizonte MG, Brazil.
,
Paulo Pereira Christo
1   Universidade Federal de Minas Gerais, Faculdade de Medicina, Centro de Investigação de Esclerose Múltipla (CIEM), Belo Horizonte MG, Brazil.
,
Thiago Gonçalves Fukuda
2   Universidade Federal da Bahia (UFBA), Faculdade de Medicina da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador BA, Brazil.
,
José Artur Costa D’Almeida
3   Hospital Geral de Fortaleza, Neuroimunologia, Fortaleza CE, Brazil.
,
Milena Sales Pitombeira
3   Hospital Geral de Fortaleza, Neuroimunologia, Fortaleza CE, Brazil.
,
Sheila Castro-Suarez
4   Centro Básico de Investigación en Demencia y Enfermedades Desmielinizantes del Sistema Nervioso, Lima, Peru.
,
Claudia Pestchanker
5   Hospital Central “Dr. Ramón Carrillo”, Departamento de Neurología, San Luis, Argentina.
,
Juan Rojas
6   Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina.
,
Verónica Tkachuk
7   Universidad de Buenos Aires, Hospital de Clínicas “José de San Martín”, Servicio de Neurología, Sección de Neuroinmunología y Enfermedades Desmielinizantes, Buenos Aires, Argentina.
,
Pablo Lopez
8   Hospital Alemán, Departamento de Neurociencias, Unidad de Neuroinmunología, Buenos Aires, Argentina.
,
Edgar Carnero Contentti
8   Hospital Alemán, Departamento de Neurociencias, Unidad de Neuroinmunología, Buenos Aires, Argentina.
,
Maria Lucia Brito Ferreira
9   Hospital da Restauração, Recife PE, Brazil.
,
Vanessa Daccach
10   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.
,
Maria Fernanda Mendes
11   Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo SP, Brazil.
,
Alfredo Damasceno
12   Universidade Estadual de Campinas (Unicamp), Campinas SP, Brazil.
,
Edgar Patricio Correa-Diaz
13   Pontificia Universidad Católica del Ecuador (PUCE), Hospital Carlos Andrade Marín, Quito, Ecuador.
,
Irene Treviño-Frenk
14   Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán,” Ciudad de México, Mexico.
,
Carlos Navas
15   Clínica Universitaria Colombia, Bogotá, Colombia.
,
Jefferson Becker
16   Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre RS, Brazil.
,
Lorna Galleguillos
17   Clínica Alemana y Universidad del Desarrollo, Santiago, Chile.
,
Carlos Oehninger
18   Universidad de la República Uruguay (UDELAR), Facultad de Medicina, Montevideo, Uruguay.
,
Paulo Diniz da Gama
19   Pontifícia Universidade Católica de São Paulo, Sorocaba SP, Brazil.
,
Ethel Ciampi
20   Pontificia Universidad Católica de Chile, Facultad de Medicina, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile.
,
Sidney Gomes
21   BP – A Beneficência Portuguesa de São Paulo, São Paulo SP, Brazil.
,
Marcus Vinicius Magno Gonçalves
22   Neurovie, Departamento de Neurologia - Joinville SC, Brazil.
,
Adriana Carra
23   Hospital Británico de Buenos Aires, Buenos Aires, Argentina.
,
Ibis Soto DeCastillo
24   Hospital Clínico, Maracaibo, Venezuela.
,
Henry Koiti Sato
25   Instituto de Neurologia de Curitiba, Curitiba PR, Brazil.
,
Gustavo Figueira
26   Hospital São Francisco na Providência de Deus, Rio de Janeiro RJ, Brazil.
,
Carlos Bernardo Tauil
27   Universidade de Brasília, Brasília DF, Brazil.
,
Samira Luisa Apóstolos-Pereira
28   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil.
,
Vinicius Andreoli Schoeps
28   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil.
,
Bruno Pedreira
2   Universidade Federal da Bahia (UFBA), Faculdade de Medicina da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador BA, Brazil.
,
Lara de Menezes Andrade
9   Hospital da Restauração, Recife PE, Brazil.
,
Katharina Messias
10   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.
,
Rafael Paternò Castello Dias Carneiro
29   Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo SP, Brazil.
,
Dagoberto Callegaro
28   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil.
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    Address for correspondence: Marco A. Lana Peixoto (email: marco.lanapeixoto@gmail.com).

    Abstract

    Background: Age-related changes in the immune system can affect the occurrence and clinical expression of autoimmune disorders. While some studies have explored neuromyelitis optica spectrum disorder (NMOSD) in older adults, analysis of very late-onset NMOSD (VLO-NMOSD), with onset at 70 years or older, remains limited to individual cases.

    Objective: To assess the frequency, clinical characteristics, and outcomes of VLO-NMOSD patients in a large Latin American (LATAM) NMOSD cohort.

    Methods: The study included NMOSD patients from 9 LATAM countries who met the 2015 IPND criteria. The patients were categorized into the VLO-NMOSD (≥ 70 years) and non-VLO-NMOSD (onset at < 70 years) groups, and we assessed their demographic and clinical features.

    Results: Out of 1,185 NMOSD patients, data on age at onset were available for 1,179, with 14 (1.2%) in the VLO-NMOSD group. Among these 14 patients, the median age was of 73 (71–83) years, 12 (85.7%) were female subjects, the most common presenting symptoms were myelitis and optic neuritis (10 and 7 cases respectively), and the median disease duration was of 40.9 (9.0–149.0). The median ARR was of 0.37, and the median EDSS score was of 6.0 (5.0–7.5). Compared with the non-VLO-NMOSD group, the VLO-NMOSD group contained a higher proportion of females and patients of mixed race/ethnicity, fewer Caucasians, and more cases of myelitis and optic neuritis (71.4% versus 48.1% and 50% versus 48.1% respectively). None of the cases of VLO-NMOSD presented with area postrema, cerebral, or diencephalic syndromes. The VLO-NMOSD group presented lower ARR (0.37) and higher EDSS scores (p = 0.004). Differences in other characteristics between the groups did not reach statistical significance.

    Conclusion: Very late-onset NMOSD is rare and demonstrates unique clinical characteristics, with more severe outcomes. Notably, VLO-NMOSD in LATAM presents with optic neuritis more frequently at onset compared with other population series.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

    Publikationsverlauf

    Artikel online veröffentlicht:
    02. Oktober 2024

    © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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