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Status of the neuromyelitis optica spectrum disorder in Latin America

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dc.contributor.author Rivera, Víctor M.
dc.contributor.author Hamuy, Fernando
dc.contributor.author Rivas, Verónica
dc.contributor.author Gracia, Fernando
dc.contributor.author Rojas, Juan Ignacio
dc.contributor.author Bernardi Bichuetti, Denis
dc.contributor.author Villa, Andrés
dc.contributor.author Daccach Marques, Vanessa
dc.contributor.author Soto, Arnoldo
dc.contributor.author Bertado, Brenda
dc.contributor.author Treviño Frenk, Irene
dc.contributor.author Galleguillos Goiry, Lorna
dc.contributor.author Quiñones, Jairo
dc.contributor.author Ramírez, Deyanira A.
dc.contributor.author Caparo Zamalloa, César
dc.contributor.author Ciampi, Ethel
dc.contributor.author Lana Peixoto, Marco A.
dc.contributor.author Rodríguez, Emmanuel
dc.contributor.author Zarco, Luis
dc.contributor.author Correale, Jorge
dc.date.accessioned 2021-07-19T13:41:18Z
dc.date.available 2021-07-19T13:41:18Z
dc.date.issued 2021-06-14
dc.identifier.citation Rivera VM, Hamuy F, Rivas V, Gracia F, Rojas JI, Bichuetti DB, Villa AM, Marques VD, Soto A, Bertado B, Frenk IT, Galleguillos L, Quiñones J, Ramirez DA, Caparó-Zamalloa C, Ciampi E, Lana Peixoto M, Rodríguez E, Zarco L, Sinay V, Armas E, Becker J, Benzadón A, Lopez E, Contentti EC, Correa-Diaz EP, Diaz A, Fleitas CV, Playas G, Molina O, Rojas E, Sato D, Soto I, Céspedes JV, Correale J, Barboza A, Monterrey P, Candelario A, Tavolini DR, Parajeles A, Pujol BS, Diaz de la Fe A, Alonso R, Bolaña C, Guzman MK, Carrá A, Gamarra OG, Raggio JV, Rodriguez LC, Ramirez NE, Ordoñez L, Skromne E, Portillo LL, Canabal AP, Weiser R, Sirias V, Calderón RF, Cornejo EA, Hernández M, Quiroz JCD, Garcia LA, Cedeño CO, Martínez J, Abad-Herrera P. Status of the neuromyelitis optica spectrum disorder in Latin America. Mult Scler Relat Disord. 2021 Jun 15;53:103083. doi: 10.1016/j.msard.2021.103083 es_ES
dc.identifier.uri https://doi.org/10.1016/j.msard.2021.103083
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/528
dc.description.abstract Background Neuromyelitis optica spectrum disorders (NMOSD) is an increasing diagnostic and therapeutic challenge in Latin America (LATAM). Despite the heterogeneity of this population, ethnic and socioeconomic commonalities exist, and epidemiologic studies from the region have had a limited geographic and population outreach. Identification of some aspects from the entire region are lacking. Objectives To determine ethnic, clinical characteristics, and utilization of diagnostic tools and types of therapy for patients with NMOSD in the entire Latin American region. Methods The Latin American Committee for Treatment and Research in MS (LACTRIMS) created an exploratory investigational survey addressed by Invitation to NMOSD Latin American experts identified through diverse sources. Data input closed after 30 days from the initial invitation. The questionnaire allowed use of absolute numbers or percentages. Multiple option responses covering 25 themes included definition of type of practice; number of NMOSD cases; ethnicity; utilization of the 2015 International Panel criteria for the diagnosis of Neuromyelitis optica (IPDN); clinical phenotypes; methodology utilized for determination of anti-Aquaporin-4 (anti­ AQP4) antibodies serological testing, and if this was performed locally or processed abroad; treatment of relapses, and long-term management were surveyed. Results We identified 62 investigators from 21 countries reporting information from 2154 patients (utilizing the IPDN criteria in 93.9% of cases), which were categorized in two geographical regions: North-Central, including the Caribbean (NCC), and South America (SA). Ethnic identification disclosed Mestizos 61.4% as the main group. The most common presenting symptoms were concomitant presence of optic neuritis and transverse myelitis in 31.8% (p=0.95); only optic neuritis in 31.4% (more common in SA), p<0.001); involvement of the area postrema occurred in 21.5% and brain stem in 8.3%, both were more frequent in the South American cases (p<0.001). Anti-AQP4 antibodies were positive in 63.9% and anti-Myelin Oligodendrocyte Glycoprotein (MOG) antibodies in 4.8% of total cases. The specific laboratorial method employed was not known by 23.8% of the investigators. Acute relapses were identified in 81.6% of cases, and were treated in 93.9% of them with intravenous steroids (IVS); 62.1% with plasma exchange (PE), and 40.9% with intravenous immunoglobulin-G (IVIG). Therapy was escalated in some cases due to suboptimal initial response. Respondents favored Rituximab as long-term therapy (86.3%), whereas azathioprine was also utilized on 81.8% of the cases, either agent used indistinctly by the investigators according to treatment accessibility or clinical judgement. There were no differences among the geographic regions. Conclusions This is the first study including all countries of LATAM and the largest cohort reported from a multinational specific world area. Ethnic distributions and phenotypic features of the disease in the region, challenges in access to diagnostic tools and therapy were identified. The Latin American neurological community should play a determinant role encouraging and advising local institutions and health officials in the availability of more sensitive and modern diagnostic methodology, in facilitating the the access to licensed medications for NMOSD, and addressing concerns on education, diagnosis and management of the disease in the community. es_ES
dc.language.iso eng es_ES
dc.publisher Elsevier es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Neuromyelitis Optica es_ES
dc.subject Neuromielitis Óptica es_ES
dc.subject Latin America es_ES
dc.subject América Latina es_ES
dc.subject Socioeconomic Factors es_ES
dc.subject Factores Socioeconómicos es_ES
dc.title Status of the neuromyelitis optica spectrum disorder in Latin America es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Rivera, Víctor M. Baylor College of Medicine; Estados Unidos.
dc.description.fil Fil: Hamuy, Fernando. Centro Nacional de Esclerosis Múltiple; Paraguay.
dc.description.fil Fil: Rivas, Verónica. Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suarez"; México.
dc.description.fil Fil: Gracia, Fernando. Hospital Santo Tomas; Panamá.
dc.description.fil Fil: Rojas, Juan Ignacio. Centro de Esclerosis Múltiple de Buenos Aires; Argentina.
dc.description.fil Fil: Bernardi Bichuetti, Denis. Universidade Federal de Sao Paulo; Brasil.
dc.description.fil Fil: Villa, Andrés. Hospital Ramos Mejía; Argentina.
dc.description.fil Fil: Daccach Marques, Vanessa. Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto; Brasil.
dc.description.fil Fil: Soto, Arnoldo. Centro Medico Docente La Trinidad; Venezuela.
dc.description.fil Fil: Bertado, Brenda. Instituto Mexicano del Seguro Social; México.
dc.description.fil Fil: Trevino Frenk, Irene. lnstituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"; México.
dc.description.fil Fil: Galleguillos, Lorna. Clínica Alemana de Santiago; Chile.
dc.description.fil Fil: Quiñones, Jairo. Fundación Valle del Lili; Colombia.
dc.description.fil Fil: Ramírez, Deyanira A. Hospital Docente Padre Bellini; República Dominicana.
dc.description.fil Fil: Caparó-Zamalloa, César. lnstituto Nacional de Ciencias Neurológicas; Perú.
dc.description.fil Fil: Ciampi, Ethel. Pontificia Universidad Católica de Chile; Chile.
dc.description.fil Fil: Lana Peixoto, Marco. Universidade Federal de Minas Gerais; Brasil.
dc.description.fil Fil: Rodríguez, Emmanuel. Centro Médico Nacional "La Raza"; México.
dc.description.fil Fil: Zarco, Luis. Pontificia Universidad Javeriana; Colombia.
dc.description.fil Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.
dc.relation.ispartofCOUNTRY Países Bajos
dc.relation.ispartofCITY Amsterdam
dc.relation.ispartofTITLE Multiple sclerosis and related disorders
dc.relation.ispartofISSN 2211-0356
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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