Neuromyelitis optica-spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system (CNS). It may be reccurent in time. It preferably affects the optic nerve and spinal cord . Several antibodies like aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibody have been involved in its pathophisiology. Currently, there is several immunomodulatory treatments that seem effective stopping disease progression. Thus, made a early diagnostic is essentially in the prognosis of the disease.
To describe the baseline characteristics of Southwestern-european population cohort of patients diagnosed with NMOSD
Retrospective observational study in patients diagnosed with NMOSD from January 2015 to May 2020 at Virgen Macarena Hospital, Seville, Spain. Demographic/disease characteristics, previous DMTs, adverse events, changes in disability, and cerebral MRI findings were collected at enrolment.
16 patients were diagnosed with NMOSD in accordance with 2015 International Panel for NMO Diagnosis criteria. All of them were womens. Average age 49 (10.6,SD). Mean time since clinical onset was 6,34 years (3.7,SD) Diagnostic delay was 3 years (3,SD). 11 patients were AQP4 antibody positive by indirect inmunofluorescence (IIF) assay (69%). 5 of patients were AQP4 and myelin oligodendrocyte glycoprotein (MOG) antibodies seronegative (31%). 3 patiens had oligoclonals bands in LCR (19%)
Mean EDSS increased from 4 to 4.1 after a mean follow-up of 3.34 years.
7 patients are treated with Rituximab (RTX)(44%), 6 patients with Azathioprine (AZT) (38%), 1 patients receive intravenous inmunoglobuline(6%) and two patients have not maintenance treatment (13%). One patient has presented one clinical relapse since current treatment administration(6%) Mean 2.98 years.
Longitudinally extensive transverse myelitis (LETM) was responsible for clinical onset in 8 patients (50%). 6 patients (37,5%) sought medical attention for first time due to Unilateral optic Neuritis, 1 patient had LETM and optic neuritis and 1 patient presented a isolated area postrema syndrome (intractable hiccups and vomiting).
Our sample presents similar characteristics than other populations published. The current inmunotherapy agents seem to be a safe and effective treatment for control disease progression. Thus, an acute and early diagnostic would be related with a better outcome.