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撒哈拉以南非洲国家的视神经脊髓炎谱系疾病(NMO-SD):16 例塞内加尔病例的初步研究。

Neuromyelitis optica spectrum disorders (NMO-SD) in a Sub-Saharan Africa country: A preliminary study of sixteen Senegalese cases.

机构信息

Neurology Department of Fann Teaching Hospital, BP 5035, Dakar, Senegal.

Neurology Department of Fann Teaching Hospital, BP 5035, Dakar, Senegal.

出版信息

Mult Scler Relat Disord. 2019 Jan;27:179-183. doi: 10.1016/j.msard.2018.10.108. Epub 2018 Oct 26.

Abstract

BACKGROUND

Neuromyelitis optica (NMO) is an autoimmune disease of the central nervous system. In Sub-Saharan Africa, publications are rare and deal with isolated cases. Our goal was to analyze the characteristics of NMO spectrum disorders in a Senegalese cohort compiled in Dakar.

PATIENTS AND METHOD

This was a retrospective descriptive study conducted at the Neurology Department of Fann Teaching Hospital. We included all patients with NMO-SD according to the 2014 diagnostic criteria.

RESULTS

Sixteen patients were enrolled, 4 men and 12 women with an average age of 30 years. Ten patients (62.5%) presented an acute myelopathy associated with retrobulbar optic neuritis and 5 (31.25%) had isolated spinal cord injury. Spinal MRI showed abnormal cervical (6 patients), dorsal (4 patients), bulbar-cervical (3 patients) or cervico-dorsal (2 patients) signal extended (≥3 vertebral segments) of the spinal cord. Visual evoked potentials (VEP) showed demyelinating optic nerve involvement in 8 patients. Ten patients were positive to AQP-4 IgG. Systemic corticosteroid therapy was the rule in all patients, associated with azathioprine in 10 of them. The clinical course at 3 months was predominantly favourable (10 patients).

CONCLUSION

This cohort is the first one compiled in Dakar. African multicentric epidemiological studies are needed.

摘要

背景

视神经脊髓炎(NMO)是一种中枢神经系统自身免疫性疾病。在撒哈拉以南非洲,发表的文献很少,且多为个案报道。我们的目标是分析达喀尔的塞内加尔队列中 NMO 谱系障碍的特征。

患者和方法

这是一项在 Fann 教学医院神经科进行的回顾性描述性研究。我们纳入了所有符合 2014 年诊断标准的 NMO-SD 患者。

结果

共纳入 16 名患者,其中 4 名男性,12 名女性,平均年龄为 30 岁。10 名患者(62.5%)表现为急性脊髓炎合并球后视神经炎,5 名(31.25%)为单纯脊髓损伤。脊髓 MRI 显示颈段(6 例)、胸段(4 例)、延髓颈段(3 例)或颈胸段(2 例)脊髓异常信号(≥3 个椎体节段)延伸。8 名患者的视觉诱发电位(VEP)显示脱髓鞘视神经受累。10 名患者的 AQP-4 IgG 阳性。所有患者均接受全身皮质类固醇治疗,其中 10 例联合硫唑嘌呤治疗。3 个月时的临床病程主要是有利的(10 例)。

结论

这是达喀尔首次汇编的队列。需要开展非洲多中心的流行病学研究。

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