Patients with very late-onset neuromyelitis optica spectrum disorder：clinical analysis of 12 cases
- VernacularTitle:12例更为晚发型视神经脊髓炎谱系疾病患者临床特点分析
- Author:
Hui LI
1
;
Xiaoxi HUANG
1
;
Liheng LI
1
Author Information
- Publication Type:Journal Article
- Keywords: Neuromyelitis Optica Spectrum Disorders（NMOSDs） or Neuromyelitis Optica（Devic syndrome） ； AQP4-Ab（Antiaquaporin-4 antibody） positive ； Very late-onset or elderly onset
- From: Journal of Apoplexy and Nervous Diseases 2020;37(3):213-218
- CountryChina
- Language:Chinese
- Abstract: Objective Report and analyze the clinical features，diagnosis，and prognosis of 3 patients with elderly-onset（age>75 years） neuromyelitis Optica spectrum disorders（NMOSDs），reviewed previous pieces of literature to improve the risk and understanding of NMOSD in elderly patients. Methods We searched the domestic and international databases in the past 10 years，to collect the case report of patients with NMOSDs over the age of 75 years，along with three cases discovered in the neurology department of the First Affiliated Hospital of Zhengzhou University. The clinical features，laboratory tests and treatment，were retrospectively analyzed. Results A total of 12 patients with NMOSDs>75 years old were enrolled in this study，including 7 females and 5 males，with an average age of onset（82.67±4.42） years. All patients were diagnosed with longitudinally extensive transverse myelitis（LETM），and the single-phase course was the majority. The AQP4 test was positive in all cases and the MRI was illustrated that mainly caused the thoracic spinal cord. Twelve cases were treated with intravenous methylprednisolone（IVMP）1 g daily for 3 to 5 days，3 cases were combined with plasma exchange（PLEX），4 cases were treated with immunosuppression，and 5 cases had a relapse，9 cases were effective，2 cases were markedly effective，3 cases were worsened. Three patients died during treatment and follow-up. Conclusion Patients with very late-onset NMOSDs are more likely to have LETM，higher disability rates. IVMP plus PLEX is more effective than IVMP alone，But the benefit of immunosuppression is unclear in clinical practice and observational studies.
- Full text:202408021149158788912例更为晚发型视神经脊髓炎谱系疾病患者临床特点分析.pdf
