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. 2023 May;44(5):1731-1737.
doi: 10.1007/s10072-023-06611-4. Epub 2023 Jan 16.

Neuromyelitis optica spectrum disorders with and without associated autoimmune diseases

Edgar Carnero Contentti  1 , Pablo A López  2 , Juan Pablo Pettinicchi  2 , Verónica Tkachuk  3 , Vanessa Daccach Marques  4 , Ibis Soto de Castillo  5 , Edgardo Cristiano  6 , Liliana Patrucco  6 , Alejandro Caride  2 , Juan Ignacio Rojas  6
Affiliations

Neuromyelitis optica spectrum disorders with and without associated autoimmune diseases

Edgar Carnero Contentti et al. Neurol Sci. 2023 May.

Abstract

Objectives: We aimed to determinate the frequency of this association and compare the features of neuromyelitis optica spectrum disorder (NMOSD) with and without associated autoimmune diseases (AD) in a Latin American (LATAM) population in clinical practice.

Methods: We retrospectively reviewed the medical records of patients with NMOSD according to the 2015 diagnostic criteria. Patients from Argentina (n=77), Brazil (n=46), and Venezuela (n=17) were enrolled and classified into two groups as follows: with AD or without AD. Clinical, paraclinical (including aquaporin-4 antibodies (AQP4-ab) status), magnetic resonance imaging (MRI), and prognosis data were analyzed and compared. Kaplan-Meier (KM) and the Nelson-Aalen estimator analyses were performed to estimate both time and the cumulative hazard risk of disability reaching an EDSS≥4; and time for the first recurrence.

Results: Out of 140 patients, 33 (23.5%) patients had associated an AD at presentation. The most frequent associated AD was Hashimoto disease (n=10) followed by lupus (n=7) and Sjogren's syndrome (n=6). However, rituximab use (42.4% vs. 21.5%, p=0.02), female gender (82.2% vs. 100%, p=0.006), corticospinal lesions on MRI (0% vs. 12.5%, p=0.01) at onset, and positivity for antinuclear antibodies (21.2% vs. 48.4%, p=0.03) were significantly associated with NMOSD patients with AD in comparison to NMOSD patients without AD. No differences were found in other clinical and paraclinical aspects between groups. KM and Nelson-Aalen estimator analyses did not show differences between groups.

Conclusion: NMOSD patients associated with AD were observed in 23.5%. In addition, NMOSD patients with and without associated AD were similar in most evaluated features.

Keywords: Autoimmune diseases; Latin America; NMOSD; Prognosis.

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