Multiple sclerosis outcome and morbi-mortality of a Brazilian cohort patients

Abstract

-We studied the clinical and evolution characteristics of multiple sclerosis (MS) patients followed since the onset of HUCFF/UFRJ in 1978. The diagnosis of MS was based on Poser's et al. and MC Donald's et al. criteria. From 188 patients, 122 were included. Eighty-five were females. The mean age onset was 32.2 yearsold (range 6.0 to 61.0±10.3), mainly Caucasians (82/67%). The relapsing-remitting course (MSRR) was more frequent (106/86.8%). Monosymptomatic onset was significantly more frequent in Caucasians than in AfroBrazilians (p<0.05). Seventeen patients had benign form of MS and these patients presented association with MSRR when compared with severe form (p=0.01). The mortality rate was 2.12% (4 patients died). This study was similar to other Brazilian series with regard to sex and age, and lack of correlation between EDSS and number of relapses; it confirmed south-southeast African-descendants gradient distribution and association between first mono-symptomatic relapses and Caucasian; we found lower frequency of benign forms.KEy WoRDS: multiple sclerosis, mortality, morbidity, epidemiology, Brazil. Caracteristicas clínico-evolutivas e morbi-mortalidade de uma coorte de pacientes brasileiros com esclerose múltipla Resumo -Estudamos as características clínico-evolutivas de pacientes com esclerose múltipla (EM) acompanhados no HUCFF-UFRJ desde 1978. Foram usados critérios de Poser et al. e MC Donald et al. para o diagnóstico de EM.De 188, 122 foram incluídos. oitenta e cinco eram mulheres. A média de idade de início foi 32,2 anos (6,0-61,0±10,3), predominando caucasianos (n=82/67%). A forma recorrente-remitente (EMRR) foi mais freqüente (n=106/86,8%). Formas mono-sintomáticas no primeiro surto foram significativamente mais freqüentes em caucasianos do que em afro-brasileiros (p<0,05). Dezessete pacientes apresentavam a forma benigna (13,9%) e 43 a grave (35,2%). A forma benigna foi associada com a EMRR (p=0,01). A taxa de letalidade 2,12% (4 óbitos). Nossos resultados são semelhantes aos de outras séries brasileiras no que se refere ao sexo e idade, e falta de correlação entre EDSS e número de surtos; confirmamos gradiente sul-sudeste de distribuição afro-descendente, associação significativa entre primeiro surto mono-sintomático e caucasianos e menor freqüência de formas benignas.

Multiple sclerosis epidemiology in Latin America: An updated survey

“…After full-text review, 14 met inclusion criteria and were selected for data abstraction and analysis of incidence-prevalence (Figure 1). 14–37 Information was obtained from nine countries (Figure 2). Regarding incidence, we found five studies (French West Indies, Argentina and Panama) that evaluated this issue.…”

Clinical response to interferon beta and glatiramer acetate in multiple sclerosis patients: a Brazilian cohort

“…Cree et al observed that 36 Africandescent compared with 616 white Caucasians with MS had a poorer response to interferon 4 . In Brazil, a third of patients with MS are African-descent 1,3 . In this context, monitoring of therapeutic responses to immunomodulators is critical for the patient, who now lives in an era of therapeutic strategies and resources that have been available for less than two decades.…”

Acute disseminated encephalomyelitis: clinical features, HLA DRB1*1501, HLA DRB1*1503, HLA DQA1*0102, HLA DQB1*0602, and HLA DPA1*0301 allelic association study

“…The similar clinical characteristics of ADEM and MS constitute one of the major problems among the differential diagnosis of MS and other primary inflammatory demyelinating diseases of the CNS [5][6][7]9,11,19,25,26 . ADEM has been considered a disease with favorable long term diagnosis, which is not commonly seen in patients with MS 9,11,13 .…”