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NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis

(1) Background: The emergence of white matter lesions in the central nervous system (CNS) can lead to diagnostic dilemmas. They are a common radiological symptom and their patterns may overlap CNS or systemic diseases and provoke underdiagnosis or misdiagnosis. The aim of the study was to assess fac...

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Autores principales: Szewczyk, Anna K., Papuć, Ewa, Mitosek-Szewczyk, Krystyna, Woś, Michał, Rejdak, Konrad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313254/
https://www.ncbi.nlm.nih.gov/pubmed/35884693
http://dx.doi.org/10.3390/brainsci12070885
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author Szewczyk, Anna K.
Papuć, Ewa
Mitosek-Szewczyk, Krystyna
Woś, Michał
Rejdak, Konrad
author_facet Szewczyk, Anna K.
Papuć, Ewa
Mitosek-Szewczyk, Krystyna
Woś, Michał
Rejdak, Konrad
author_sort Szewczyk, Anna K.
collection PubMed
description (1) Background: The emergence of white matter lesions in the central nervous system (CNS) can lead to diagnostic dilemmas. They are a common radiological symptom and their patterns may overlap CNS or systemic diseases and provoke underdiagnosis or misdiagnosis. The aim of the study was to assess factors influencing the underdiagnosis of neuromyelitis optica spectrum disorder (NMOSD) as well as to estimate NMOSD epidemiology in Lubelskie voivodeship, Poland. (2) Methods: This retrospective study included 1112 patients, who were made a tentative or an established diagnosis of acute or subacute onset of neurological deficits. The evaluation was based on medical history, neurological examination, laboratory and radiographic results and fulfilment of diagnosis criteria. (3) Results: Up to 1.62 percent of patients diagnosed with white matter lesions and up to 2.2% of the patients previously diagnosed with MS may suffer from NMOSD. The duration of delayed diagnosis is longer for males, despite the earlier age of onset. Seropositive cases for antibodies against aquaporin-4 have worse prognosis for degree of disability. (4) Conclusions: Underdiagnosis or misdiagnosis in NMOSD still remains a problem in clinical practice and has important implications for patients. The incorrect diagnosis is caused by atypical presentation or NMOSD-mimics; however, covariates such as gender, onset and diagnosis age may also have an influence.
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spelling pubmed-93132542022-07-26 NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis Szewczyk, Anna K. Papuć, Ewa Mitosek-Szewczyk, Krystyna Woś, Michał Rejdak, Konrad Brain Sci Article (1) Background: The emergence of white matter lesions in the central nervous system (CNS) can lead to diagnostic dilemmas. They are a common radiological symptom and their patterns may overlap CNS or systemic diseases and provoke underdiagnosis or misdiagnosis. The aim of the study was to assess factors influencing the underdiagnosis of neuromyelitis optica spectrum disorder (NMOSD) as well as to estimate NMOSD epidemiology in Lubelskie voivodeship, Poland. (2) Methods: This retrospective study included 1112 patients, who were made a tentative or an established diagnosis of acute or subacute onset of neurological deficits. The evaluation was based on medical history, neurological examination, laboratory and radiographic results and fulfilment of diagnosis criteria. (3) Results: Up to 1.62 percent of patients diagnosed with white matter lesions and up to 2.2% of the patients previously diagnosed with MS may suffer from NMOSD. The duration of delayed diagnosis is longer for males, despite the earlier age of onset. Seropositive cases for antibodies against aquaporin-4 have worse prognosis for degree of disability. (4) Conclusions: Underdiagnosis or misdiagnosis in NMOSD still remains a problem in clinical practice and has important implications for patients. The incorrect diagnosis is caused by atypical presentation or NMOSD-mimics; however, covariates such as gender, onset and diagnosis age may also have an influence. MDPI 2022-07-06 /pmc/articles/PMC9313254/ /pubmed/35884693 http://dx.doi.org/10.3390/brainsci12070885 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szewczyk, Anna K.
Papuć, Ewa
Mitosek-Szewczyk, Krystyna
Woś, Michał
Rejdak, Konrad
NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title_full NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title_fullStr NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title_full_unstemmed NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title_short NMOSD—Diagnostic Dilemmas Leading towards Final Diagnosis
title_sort nmosd—diagnostic dilemmas leading towards final diagnosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313254/
https://www.ncbi.nlm.nih.gov/pubmed/35884693
http://dx.doi.org/10.3390/brainsci12070885
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