Hospital da Lagoa, Ministério da Saúde, Rio de Janeiro, Brazil.
Mult Scler. 2014 Mar;20(3):374-81. doi: 10.1177/1352458513495580. Epub 2013 Aug 22.
It is recognized that there is a particular geographic and ethnic distribution of neuromyelitis optica (NMO) among Caucasian and non-Caucasian populations.
To review the diagnoses of patients whom were enrolled in the South Atlantic Project, a Brazilian multiple sclerosis (MS) survey performed from 1995-1998, and to identify NMO and MS case frequencies.
We reviewed the data from a 10-year follow-up of MS patients. To apply the current diagnostic criteria, the neurologists were asked to collect clinical and laboratory data from the medical records of study patients treated from 1999-2009.
The spectrum of inflammatory demyelinating disease in 322 patients (67% white; 33% African-Brazilian) was: 49 (15%) with NMO; 14 (4%) with NMO syndromes; 10 (3%) with acute disseminated encephalomyelitis (ADEM); one isolated tumefactive brain lesion; 249 (77%) with MS (151 with relapsing-remitting MS (RRMS), 70 with secondary progressive MS (SPMS) and 27 with primary progressive MS (PPMS)). Disability was more severe in NMO and PPMS. One-third of the NMO patients had died.
The frequency of NMO was 6.8% in São Paulo and 20.5% in Rio de Janeiro, and mainly seen in persons of African descent, which strengthens the hypothesis of there being an ethnic association of this disease. We recommend that epidemiological studies on MS that were performed previously be reviewed again, to ensure more accurate diagnoses.
神经髓鞘炎（NMO）在白种人和非白种人群中的地理和种族分布存在差异，这一点已得到认可。
回顾参与南大西洋项目（巴西多发性硬化症调查）的患者的诊断结果，该项目于 1995-1998 年进行，以确定 NMO 和 MS 的病例频率。
我们回顾了对 MS 患者进行的 10 年随访数据。为了应用当前的诊断标准，要求神经病学家从 1999-2009 年接受治疗的研究患者的病历中收集临床和实验室数据。
322 名患者（67%为白人；33%为非洲裔巴西人）的炎症性脱髓鞘疾病谱为：49 例（15%）为 NMO；14 例（4%）为 NMO 综合征；10 例（3%）为急性播散性脑脊髓炎（ADEM）；1 例孤立性肿块样脑病变；249 例（77%）为 MS（151 例为复发缓解型 MS（RRMS），70 例为继发进展型 MS（SPMS），27 例为原发进展型 MS（PPMS））。NMO 和 PPMS 患者的残疾程度更严重。三分之一的 NMO 患者已经死亡。
圣保罗的 NMO 发病率为 6.8%，里约热内卢的 NMO 发病率为 20.5%，主要见于非洲裔人群，这进一步证实了该病与种族有关的假说。我们建议重新审查之前进行的关于 MS 的流行病学研究，以确保更准确的诊断。
