Neuromyelitis optica: phenotypic characteristics in a Brazilian case series

Abstract

The definition of neuromyelitis optica (NMO) is still evolving. In 2015, the International Panel for NMO Diagnosis was convened to develop revised diagnostic criteria. There have been few studies on NMO in the Brazilian population. Objective To describe the characteristics of 34 Brazilian NMO patients. To evaluate the contribution of the 2015 criteria to the diagnosis of NMO spectrum disorders (NMOSD) in 40 patients with longitudinal extensive transverse myelitis (LEMT). Methods This is a retrospective, descriptive and analytic study. Results Among NMO patients, there was a predominance of women, with onset in the fourth decade of life, and AQP4-IgG seropositivity in 73.5%. The diagnosis of NMOSD was established in 37.5% of LETM patients according to AQP4-IgG positivity and in 5% of LETM patients if the AQP4-IgG result was unknown. Conclusions The characteristics of this series are similar to those of other Western populations. The AQP4-IgG testing assists in the diagnosis of NMOSD.

Epidemiology of neuromyelitis optica in Latin America

“…Demographic and clinical characteristics of patients diagnosed with the aid of criteria proposed by Wingerchuk et al. (1999, 2006) were described in the Caribbean Islands, 16 , 20 in the Southeast 21 – 23 and the Midwest regions of Brazil 24 and in Mexico City. 17 The patients were mainly females between 30 and 40 years old.…”

“…Table 4 describes the data from five studies in LATAM that analyzed the presence of NMO-IgG antibody in NMO patients. 21 , 22 , 24 , 26 , 31 The presence of the antibody varied from 33% to 73.5%.…”

Neuromyelitis optica: it is time to move one step further

“…On the other hand, it can pose problems and diagnostic errors for the non-specialist. As a result, the best way to minimize errors and improve diagnostic accuracy in general is to know, as much as possible, the range of clinical manifestations of the disease as well as its behavior in the long term.In this issue of Arquivos de Neuropsiquiatria, Del Negro et al 3 add clinical information about 34 Brazilian patients diagnosed with NMOSD and 40 patients with longitudinally extensive transverse myelitis (LETM). There are few differences from the previously published Brazilian series, which is not a weakness of the study but confirms our knowledge and reinforces the role of reliable science in replicating results.…”

“…In this issue of Arquivos de Neuropsiquiatria, Del Negro et al 3 add clinical information about 34 Brazilian patients diagnosed with NMOSD and 40 patients with longitudinally extensive transverse myelitis (LETM). There are few differences from the previously published Brazilian series, which is not a weakness of the study but confirms our knowledge and reinforces the role of reliable science in replicating results.…”

“…Del Negro et al 3 discuss the characteristics of other Brazilian series (in table 4) and a quick glance shows 155 cases of NMOSD patients studied since 2002. The problem of the small size of the series could be solved with multicenter studies and the creation of a national database 7 .…”