Central nervous system idiopathic inflammatory demyelinating disorders in south americans: a descriptive, multicenter, cross-sectional study

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dc.creatorAlvarenga, Regina Maria Papais
dc.creatorVasconcelos, Claudia Cristina Ferreira
dc.creatorCarra, Adriana
dc.creatorSoto de Castillo, Ibis
dc.creatorFlorentin, Sara
dc.creatorDiaz de Bedoya, Fernando Hamuy
dc.creatorMandler, Raul
dc.creatorTravassos, Luiza Campanella de Siervi
dc.creatorPimentel, Maria Lucia Vellutini
dc.creatorAlvarenga, Marina Papais
dc.creatorAlvarenga, Marcos Papais
dc.creatorGrzesiuk, Anderson Kuntz
dc.creatorPereira, Ana Beatriz Calmon Nogueira da Gama
dc.creatorGomes Neto, Antonio Pereira
dc.creatorVelasquez, Carolina
dc.creatorSoublette, Carlos
dc.creatorVeronica Fleitas, Cynthia
dc.creatorDiniz, Denise Sisterolli
dc.creatorArmas, Elizabeth
dc.creatorSilva, Elizabeth Batista da
dc.creatorHernandez, Freda
dc.creatorPereira, Fernanda Ferreira Chaves da Costa
dc.creatorBorges, Heloise Helena Siqueira
dc.creatorCabeça, Hideraldo Luis Souza
dc.creatorSanchez, Jose
dc.creatorBrooks, Joseph Bruno Bidin
dc.creatorGonçcalves, Marcus Vinicius Magno
dc.creatorFreitas, Maria Cristina Del Negro Barroso
dc.creatorRavelo, María Elena
dc.creatorCastillo, Maria Carlota
dc.creatorFerreira, Maria Lúcia Brito
dc.creatorRocha, Maria Sheila Guimarães
dc.creatorParolin, Mônica Koncke Fiuza
dc.creatorMolina, Omaira
dc.creatorMarinho, Patricia Beatriz Christino
dc.creatorChristo, Paulo Pereira
dc.creatorMelo, Renata Brant de Souza
dc.creatorPessanha Neto, Silvio
dc.creatorMorais, Solange Maria das Graças de
dc.creatorMachado, Suzana Costa
dc.creatorNeri, Vanderson Carvalho
dc.creatorFragoso, Yara Dadalti
dc.creatorAlvarenga, Helcio
dc.creatorThuler, Luiz Claudio Santos
dc.date.accessioned2019-01-31T10:55:27Z
dc.date.available2019-01-31T10:55:27Z
dc.date.issued2015-07
dc.description.abstractThe idiopathic inflammatory demyelinating disease (IIDD) spectrum has been investigated among different populations, and the results have indicated a low relative frequency of neuromyelitis optica (NMO) among multiple sclerosis (MS) cases in whites (1.2%-1.5%), increasing in Mestizos (8%) and Africans (15.4%-27.5%) living in areas of low MS preva- lence. South America (SA) was colonized by Europeans from the Iberian Peninsula, and their miscegenation with natives and Africans slaves resulted in significant racial mixing. The current study analyzed the IIDD spectrum in SA after accounting for the ethnic hetero- geneity of its population. A cross-sectional multicenter study was performed. Only individu- als followed in 2011 with a confirmed diagnosis of IIDD using new diagnostic criteria were considered eligible. Patients’ demographic, clinical and laboratory data were collected. In all, 1,917 individuals from 22 MS centers were included (73.7% female, 63.0% white, 28.0% African, 7.0% Mestizo, and 0.2% Asian). The main disease categories and their associated frequencies were MS (76.9%), NMO (11.8%), other NMO syndromes (6.5%), CIS (3.5%), ADEM (1.0%), and acute encephalopathy (0.4%). Females predominated in all main cate- gories. The white ethnicity also predominated, except in NMO. Except in ADEM, the dis- ease onset occurred between 20 and 39 years old, early onset in 8.2% of all cases, and late onset occurred in 8.9%. The long-term morbidity after a mean disease time of 9.28±7.7 years was characterized by mild disability in all categories except in NMO, which was scored as moderate. Disease time among those with MS was positively correlated with the expanded disability status scale (EDSS) score (r=0.374; p=<0.001). This correlation was not observed in people with NMO or those with other NMO spectrum disorders (NMOSDs). Among patients with NMO, 83.2% showed a relapsing-remitting course, and 16.8% showed a monophasic course. The NMO-IgG antibody tested using indirect immunofluorescence (IIF) with a composite substrate of mouse tissues in 200 NMOSD cases was positive in peo- ple with NMO (95/162; 58.6%), longitudinally extensive transverse myelitis (10/30; 33.3%) and bilateral or recurrent optic neuritis (8/8; 100%). No association of NMO-IgG antibody positivity was found with gender, age at onset, ethnicity, early or late onset forms, disease course, or long-term severe disability. The relative frequency of NMO among relapsing- remitting MS (RRMS) + NMO cases in SA was 14.0%. Despite the high degree of miscege- nation found in SA, MS affects three quarters of all patients with IIDD, mainly white young women who share similar clinical characteristics to those in Western populations in the northern hemisphere, with the exception of ethnicity; approximately one-third of all cases occur among non-white individuals. At the last assessment, the majority of RRMS patients showed mild disability, and the risk for secondary progression was significantly superior among those of African ethnicity. NMO comprises 11.8% of all IIDD cases in SA, affecting mostly young African-Brazilian women, evolving with a recurrent course and causing mod- erate or severe disability in both ethnic groups. The South-North gradient with increasing NMO and non-white individuals from Argentina, Paraguay, Brazil and Venezuela confirmed previous studies showing a higher frequency of NMO among non-white populations.pt_BR
dc.identifier.citationPAPAIS-ALVARENGA, Regina Maria et al. Central nervous system idiopathic inflammatory demyelinating disorders in south americans: a descriptive, multicenter, cross-sectional study. Plos One, San Francisco, v. 10, n. 7, p. e0127757, 2015.pt_BR
dc.identifier.doi10.1371/journal.pone.0127757
dc.identifier.urihttp://repositorio.bc.ufg.br/handle/ri/16908
dc.language.isoengpt_BR
dc.publisher.countryEstados unidospt_BR
dc.publisher.departmentFaculdade de Medicina - FM (RG)pt_BR
dc.rightsAcesso Abertopt_BR
dc.titleCentral nervous system idiopathic inflammatory demyelinating disorders in south americans: a descriptive, multicenter, cross-sectional studypt_BR
dc.typeArtigopt_BR

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