Contributions
Abstract: P864
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Neuromyelitis Optica Spectrum Disorder (NMOSD) is a primary demyelinating disorder seen across all ages, more common in Asian and African countries. There is very sparse literature about late onset NMOSD.
Methods: We conducted a retrospective study from June 2014 through May 2017, at a tertiary care neuropsychiatric institute at Bengaluru, on patients who were tested positive for antibodies to Aquaporin 4 (AQP4-Ab) by cell based assay. Among 134 AQP4-Ab positive patients fulfilling 2015 international NMO diagnostic criteria,24 were late onset NMOSD (L- NMOSD) (> 45 years). They were compared with 90 adult onset (A-NMOSD) (18 to 45 years) and 20 paediatric group (P-NMOSD) (˂18 years age of onset).
Results: 134 patients had mean age of onset of 31(SD 13.1) years (range 1.5-71) with duration of illness 4.7(SD 4.58) years. L-NMOSD had female preponderance (11:1) in comparison with A-NMOSD(77:13) and P-NMOSD (9:1). Kruskal-Wallis test showed significant difference in Annualised Relapse Rate(ARR) between age groups χ2(2) = 6.77, p = 0.037,mean rank ARR of 57.63 for L-NMOSD,65.91 for A-NMOSD and 86.53 for P-NMOSD. 37.5 % of L-NMOSD had Expanded Disability Status Scale (EDSS)≥ 8 when compared to A-NMOSD(26.6%) and P-NMOSD(15%). Majority of L-NMOSD (58 %) presented with myelopathy, when compared with A-NMOSD(27.8%) and P-NMOSD (15%). 92% L-NMOSD had spinal cord involvement during their course of illness and Longitudinal Extensive Transverse Myelitis (LETM) in MRI seen in 75%. Among 134 patients,46(34%) had area postrema involvement. Only 16% L-NMOSD had area postrema involvement when compared to A-NMOSD (37.8%) and P-NMOSD(40%). 60% of L-NMOSD had autoantibodies to systemic diseases in comparison with 34.4% of A-NMOSD and 53.8% of P-NMOSD.
Conclusion: L-NMOSD patients has distinctly different clinical features and higher association with other systemic antibodies with significant morbidity. Early diagnosis and prompt treatment with effective immunosuppressants is advocated to minimize this disability.
Disclosure:
Hari Krishna Bollampalli: nothing to disclose
Netravathi M: nothing to disclose
Mahadevan A: nothing to disclose
Maya B: nothing to disclose
Venkataswamy M.M: nothing to disclose
Satishchandra P: nothing to disclose
Abstract: P864
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Neuromyelitis Optica Spectrum Disorder (NMOSD) is a primary demyelinating disorder seen across all ages, more common in Asian and African countries. There is very sparse literature about late onset NMOSD.
Methods: We conducted a retrospective study from June 2014 through May 2017, at a tertiary care neuropsychiatric institute at Bengaluru, on patients who were tested positive for antibodies to Aquaporin 4 (AQP4-Ab) by cell based assay. Among 134 AQP4-Ab positive patients fulfilling 2015 international NMO diagnostic criteria,24 were late onset NMOSD (L- NMOSD) (> 45 years). They were compared with 90 adult onset (A-NMOSD) (18 to 45 years) and 20 paediatric group (P-NMOSD) (˂18 years age of onset).
Results: 134 patients had mean age of onset of 31(SD 13.1) years (range 1.5-71) with duration of illness 4.7(SD 4.58) years. L-NMOSD had female preponderance (11:1) in comparison with A-NMOSD(77:13) and P-NMOSD (9:1). Kruskal-Wallis test showed significant difference in Annualised Relapse Rate(ARR) between age groups χ2(2) = 6.77, p = 0.037,mean rank ARR of 57.63 for L-NMOSD,65.91 for A-NMOSD and 86.53 for P-NMOSD. 37.5 % of L-NMOSD had Expanded Disability Status Scale (EDSS)≥ 8 when compared to A-NMOSD(26.6%) and P-NMOSD(15%). Majority of L-NMOSD (58 %) presented with myelopathy, when compared with A-NMOSD(27.8%) and P-NMOSD (15%). 92% L-NMOSD had spinal cord involvement during their course of illness and Longitudinal Extensive Transverse Myelitis (LETM) in MRI seen in 75%. Among 134 patients,46(34%) had area postrema involvement. Only 16% L-NMOSD had area postrema involvement when compared to A-NMOSD (37.8%) and P-NMOSD(40%). 60% of L-NMOSD had autoantibodies to systemic diseases in comparison with 34.4% of A-NMOSD and 53.8% of P-NMOSD.
Conclusion: L-NMOSD patients has distinctly different clinical features and higher association with other systemic antibodies with significant morbidity. Early diagnosis and prompt treatment with effective immunosuppressants is advocated to minimize this disability.
Disclosure:
Hari Krishna Bollampalli: nothing to disclose
Netravathi M: nothing to disclose
Mahadevan A: nothing to disclose
Maya B: nothing to disclose
Venkataswamy M.M: nothing to disclose
Satishchandra P: nothing to disclose