Neuromyelitis optica misdiagnosed as multiple sclerosis: a hospital-based study
Author(s): ,
A. Villa
Buenos Aires University, Buenos Aires, Argentina
V. Fernandez
Buenos Aires University, Buenos Aires, Argentina
L. Melamud
Buenos Aires University, Buenos Aires, Argentina
ECTRIMS Online Library. Villa A. Oct 12, 2018; 228820; P978
Andres Villa
Andres Villa
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Abstract: P978

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis

Background: Neuromyelitis optica spectrum disorders (NMOSD) is a severe inflammatory disease affecting the Central Nervous System. Despite the discovery of the specific biomarker, aquaporin-4 antibody (AQP4-Ab) more than 10 years ago, misdiagnosis remains a problem.
Objective: The aim of the study is to determine which proportion of patients with NMOSD were initially misdiagnosed as Multiple Sclerosis (MS).
Materials and methods: We performed a retrospective hospital-based study and obtained information from medical records of patients with diagnosis of NMOSD according to 2015 criteria who were referred for a medical consultation at a General Hospital in Buenos Aires, Argentina between 2006 and 2016.
Results: Of 71 NMOSD patients, we collected data from 52 patients. 12/52 (23%) were diagnosed as having MS at the beginning of the disease. Median duration of misdiagnosis was 4.5 years.
7/12 patients (58%) were diagnosed as MS before the 2006 NMO diagnostic criteria (3 with transverse myelitis and 4 with optic neuritis as first symptom). 5/12 patients (42%) were diagnosed as MS after that time (3 had optic neuritis, 1 transverse myelitis and the other one an area postrema syndrome as first symptoms).
7/12 (58%) patients were treated with disease-modifying therapy (DMT). 6/12 received beta-interferon and the other one glatiramer acetate. All of these patients persisted with relapses despite the treatment. In 11/12 misdiagnosed patients, testing for AQP4-Ab was available, being positive in 6/11 (58%), similar to the seropositivity rate in this whole sample.
Conclusions: NMOSD is frequently misdiagnosed as MS, leading to unnecessary and potentially serious risks for patients and significant implications for health care systems.
Disclosure: Nothing to disclose

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