Contributions
Abstract: P671
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: In clinical practice there is a need to validate the revised McDonald 2017 MS criteria in children with acquired demyelinating syndromes (ADS), both under and above the age of 12, and patients with encephalopathy (ADEM).
Objectives: To evaluate the diagnostic accuracy of the 2017 McDonald criteria vs the McDonald 2010 criteria to predict clinically definite MS (CDMS) in children with ADS.
Methods: 164 children (< 18 years) with an incident attack of ADS were included in a prospective multicenter study between June 2006 and December 2016. Brain MRI was performed ≤3 months after symptom onset. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy were compared between the 2010 and 2017 criteria.
Results: Among the 164 patients, 110 (67%) patients presented without encephalopathy (ADS-, female 63%; median age 14.8 years, IQR 11.3-16.1) and 54 (33%) with ADEM (female 52%; median age 4.0, IQR 2.6-6.1). Of the 110 ADS- patients, 52 (47%) were diagnosed with CDMS within a median follow-up of 4.5 years(IQR 2.6-6.7). The sensitivity was higher for the 2017 criteria than for the 2010 criteria (83%;95% CI 67-92, vs 49%;95% CI 33-65; p< .001), but the specificity was lower (73%; 95%CI 59-84 vs 87%;95%CI 74-94, p=0.02). At baseline, 48 patients fulfilled the 2017 criteria compared to 27 patients when using the 2010 criteria. The results for children without encephalopathy < 12 years were similar. In ADEM patients, 8% fulfilled the 2010 criteria and 10% the 2017 criteria at baseline, but no patient developed CDMS.
Conclusions: The McDonald 2017 criteria are more sensitive than the McDonald 2010 criteria for predicting CDMS at baseline. These criteria can also be applied in children < 12 years without encephalopathy, but not in children with ADEM.
Disclosure: Yu Yi M. Wong - reports no disclosures
C. Louk de Mol - reports no disclosures
Roos M. van der Vuurst de Vries - reports no disclosures
E. Daniëlle van Pelt - reports no disclosures
Immy A. Ketelslegers - reports no disclosures
Coriene E. Catsman-Berrevoets - reports no disclosures
Rinze F. Neuteboom - participates in trials with Sanofi Genzyme and Novartis.
Rogier Q. Hintzen - Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis
Abstract: P671
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: In clinical practice there is a need to validate the revised McDonald 2017 MS criteria in children with acquired demyelinating syndromes (ADS), both under and above the age of 12, and patients with encephalopathy (ADEM).
Objectives: To evaluate the diagnostic accuracy of the 2017 McDonald criteria vs the McDonald 2010 criteria to predict clinically definite MS (CDMS) in children with ADS.
Methods: 164 children (< 18 years) with an incident attack of ADS were included in a prospective multicenter study between June 2006 and December 2016. Brain MRI was performed ≤3 months after symptom onset. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy were compared between the 2010 and 2017 criteria.
Results: Among the 164 patients, 110 (67%) patients presented without encephalopathy (ADS-, female 63%; median age 14.8 years, IQR 11.3-16.1) and 54 (33%) with ADEM (female 52%; median age 4.0, IQR 2.6-6.1). Of the 110 ADS- patients, 52 (47%) were diagnosed with CDMS within a median follow-up of 4.5 years(IQR 2.6-6.7). The sensitivity was higher for the 2017 criteria than for the 2010 criteria (83%;95% CI 67-92, vs 49%;95% CI 33-65; p< .001), but the specificity was lower (73%; 95%CI 59-84 vs 87%;95%CI 74-94, p=0.02). At baseline, 48 patients fulfilled the 2017 criteria compared to 27 patients when using the 2010 criteria. The results for children without encephalopathy < 12 years were similar. In ADEM patients, 8% fulfilled the 2010 criteria and 10% the 2017 criteria at baseline, but no patient developed CDMS.
Conclusions: The McDonald 2017 criteria are more sensitive than the McDonald 2010 criteria for predicting CDMS at baseline. These criteria can also be applied in children < 12 years without encephalopathy, but not in children with ADEM.
Disclosure: Yu Yi M. Wong - reports no disclosures
C. Louk de Mol - reports no disclosures
Roos M. van der Vuurst de Vries - reports no disclosures
E. Daniëlle van Pelt - reports no disclosures
Immy A. Ketelslegers - reports no disclosures
Coriene E. Catsman-Berrevoets - reports no disclosures
Rinze F. Neuteboom - participates in trials with Sanofi Genzyme and Novartis.
Rogier Q. Hintzen - Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis