Contributions
Abstract: P861
Type: Poster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: NMOSD is an inflammatory central nervous system condition mediated by serum aquaporin-4 immunoglobulin G antibody (AQP4-IgG). There are few reports describing neuroimaging profile in NMOSD pediatric onset, specially using the International Painel of NMO Diagnosis (IPND) updated in 2015. To describe magnetic resonance imaging (MRI) findings.
Method: Brain, spinal cord and optic MRI were reviewed by a neuroradiology specialist in neuroimmune diseases. Inclusion criteria: patients enrolled in our neuroimmunology service from January 2005 to April 2017 whose NMOSD symptoms began before 18 years-old and met the updated 2015-IPND diagnostic criteria.
Results: MRI of sixteen patients were analyzed. Optic abnormalities: 13 (81,3%) patients had optic lesions, of them 9 (69,2%) had optic chiasm and bilateral involvement. Spinal cords abnormalities were found in 14 (87,5%) patients: ten (71,4%) had lesions characterized as longitudinally extensive transverse myelitis (LETM); segments involved were cervical (11), thoracic (12) or lumbar (3), and 12/14 (85,7%) had central lesions. Eight (57,1%) patients had gadolinium enhancement and 7 (50%) had brightspot. Area postrema/dorsal medulla lesions were found in (53,3%) patients. Brain MRI was normal in 3/16 patients and none had typical multiple sclerosis (MS) lesions. MRI lesions found were: one (7,6%) had diencephalic lesion, one (7,6%) had edematous corpus callosum lesions, 2 (15,3%) had long corticospinal tract lesions, 3 (23%) had periependymal brain lesions, 8 (61,5%) patients had periependymal brainstem lesions. Six patients with optic chiasm involvement were AQP4-IgG positive.
Conclusion: We found LETM is a common finding in pediatric NMOSD as compared with literature review. Brain findings disclosure lesions typical of NMOSD and MS lesions were not found. AQP4-IgG positivity is associated with optic chiasm involvement patients with optic neuritis (p=0,04). It is important to consider NMOSD diagnosis and early treatment in pediatric patients presenting with optic neuritis and chiasm involvement.
Disclosure:
Renata Barbosa Paolilo: nothing to disclose.
José Albino da Paz: nothing to disclose.
Samira Luisa Apostolos Pereira: received grants related to congress meetings from Genzyme and Roche.
Carolina de Medeiros Rimkus: nothing to disclose.
Ana Luiza Camara Araujo: nothing to disclose.
Lais Maria Gomes de Brito Ventura: nothing to disclose.
Milena Sales Pitombeira: nothing to disclose.
Ana Beatriz Gomes: nothing to disclose.
Aline de Moura Brasil Matos: nothing to disclose.
Pedro Henrique Bruel Torretta: nothing to disclose.
Umbertina Conti Reed: nothing to disclose.
Dagoberto Callegaro: received grants related to congress meetings from Genzyme and Roche.
Douglas Kazutoshi Sato: nothing to disclose.
Abstract: P861
Type: Poster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: NMOSD is an inflammatory central nervous system condition mediated by serum aquaporin-4 immunoglobulin G antibody (AQP4-IgG). There are few reports describing neuroimaging profile in NMOSD pediatric onset, specially using the International Painel of NMO Diagnosis (IPND) updated in 2015. To describe magnetic resonance imaging (MRI) findings.
Method: Brain, spinal cord and optic MRI were reviewed by a neuroradiology specialist in neuroimmune diseases. Inclusion criteria: patients enrolled in our neuroimmunology service from January 2005 to April 2017 whose NMOSD symptoms began before 18 years-old and met the updated 2015-IPND diagnostic criteria.
Results: MRI of sixteen patients were analyzed. Optic abnormalities: 13 (81,3%) patients had optic lesions, of them 9 (69,2%) had optic chiasm and bilateral involvement. Spinal cords abnormalities were found in 14 (87,5%) patients: ten (71,4%) had lesions characterized as longitudinally extensive transverse myelitis (LETM); segments involved were cervical (11), thoracic (12) or lumbar (3), and 12/14 (85,7%) had central lesions. Eight (57,1%) patients had gadolinium enhancement and 7 (50%) had brightspot. Area postrema/dorsal medulla lesions were found in (53,3%) patients. Brain MRI was normal in 3/16 patients and none had typical multiple sclerosis (MS) lesions. MRI lesions found were: one (7,6%) had diencephalic lesion, one (7,6%) had edematous corpus callosum lesions, 2 (15,3%) had long corticospinal tract lesions, 3 (23%) had periependymal brain lesions, 8 (61,5%) patients had periependymal brainstem lesions. Six patients with optic chiasm involvement were AQP4-IgG positive.
Conclusion: We found LETM is a common finding in pediatric NMOSD as compared with literature review. Brain findings disclosure lesions typical of NMOSD and MS lesions were not found. AQP4-IgG positivity is associated with optic chiasm involvement patients with optic neuritis (p=0,04). It is important to consider NMOSD diagnosis and early treatment in pediatric patients presenting with optic neuritis and chiasm involvement.
Disclosure:
Renata Barbosa Paolilo: nothing to disclose.
José Albino da Paz: nothing to disclose.
Samira Luisa Apostolos Pereira: received grants related to congress meetings from Genzyme and Roche.
Carolina de Medeiros Rimkus: nothing to disclose.
Ana Luiza Camara Araujo: nothing to disclose.
Lais Maria Gomes de Brito Ventura: nothing to disclose.
Milena Sales Pitombeira: nothing to disclose.
Ana Beatriz Gomes: nothing to disclose.
Aline de Moura Brasil Matos: nothing to disclose.
Pedro Henrique Bruel Torretta: nothing to disclose.
Umbertina Conti Reed: nothing to disclose.
Dagoberto Callegaro: received grants related to congress meetings from Genzyme and Roche.
Douglas Kazutoshi Sato: nothing to disclose.