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