Shah Anna A, Piche Jessica, Stewart Benjamin, Lyness Colin, Callaghan Brian, Solomon Andrew J
Department of Neurology & Rocky Mountain MS Center, University of Colorado School of Medicine, Academic Office 1, B-185, 12631 East 17th Avenue, Aurora, CO 80045, USA.
Department of Neurology, University of Michigan School of Medicine, Ann Arbor, MI, USA.
Mult Scler Relat Disord. 2023 Jan;69:104443. doi: 10.1016/j.msard.2022.104443. Epub 2022 Dec 5.
The clinical evaluation of a new diagnosis of MS typically includes serologic testing to evaluate for its many mimics, yet there is little data to guide approaches to such testing.
To evaluate for the frequency and clinical significance of serologic testing for MS diagnostic evaluations.
In a single MS subspeciality center retrospective study, new patient evaluations for MS over the course of a year were identified, and the results of serologic testing and diagnostic evaluation extracted. Retrospective longitudinal diagnostic assessment was performed to confirm the accuracy of initial serological testing assessments.
150 patients had 823 serologic tests. 40 (5%) tests were positive, and resulted in 117 additional serologic tests, 10 radiographs, and 2 biopsies. 77 (51%) patients were diagnosed with a non-demyelinating disorder. Serologic testing results did not change any diagnosis, yet in some patients, it resulted in unnecessary additional testing and diagnostic delay.
Serologic testing in the clinical assessment for routine MS resulted in unnecessary diagnostic delay, additional testing, and considerable healthcare cost.
对新诊断的多发性硬化症（MS）进行临床评估通常包括血清学检测，以评估其多种疑似病症，但几乎没有数据可指导此类检测的方法。
评估血清学检测在MS诊断评估中的频率及临床意义。
在一项单一的MS专科中心回顾性研究中，确定了一年内对MS患者的新评估情况，并提取了血清学检测结果和诊断评估结果。进行回顾性纵向诊断评估以确认初始血清学检测评估的准确性。
150名患者进行了823次血清学检测。40次（5%）检测呈阳性，导致另外进行了117次血清学检测、10次X光检查和2次活检。77名（51%）患者被诊断为非脱髓鞘性疾病。血清学检测结果未改变任何诊断，但在一些患者中，导致了不必要的额外检测和诊断延迟。
在常规MS临床评估中进行血清学检测导致了不必要的诊断延迟、额外检测以及可观的医疗费用。
