Department of Neurology, Fleni, Buenos Aires, Argentina; Institute of Biological Chemistry and Biophysics, CONICET/University of Buenos Aires, Buenos Aires, Argentina.
Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
Lancet Neurol. 2024 Oct;23(10):1035-1049. doi: 10.1016/S1474-4422(24)00256-4.
The differential diagnosis of multiple sclerosis can present specific challenges in patients from Latin America, Africa, the Middle East, eastern Europe, southeast Asia, and the Western Pacific. In these areas, environmental factors, genetic background, and access to medical care can differ substantially from those in North America and western Europe, where multiple sclerosis is most common. Furthermore, multiple sclerosis diagnostic criteria have been developed primarily using data from North America and western Europe. Although some diagnoses mistaken for multiple sclerosis are common regardless of location, a comprehensive approach to the differential diagnosis of multiple sclerosis in Latin America, Africa, the Middle East, eastern Europe, southeast Asia, and the Western Pacific regions requires special consideration of diseases that are prevalent in those locations. A collaborative effort has therefore assessed global differences in multiple sclerosis differential diagnoses and proposed recommendations for evaluating patients with suspected multiple sclerosis in regions beyond North America and western Europe.
多发性硬化症的鉴别诊断在来自拉丁美洲、非洲、中东、东欧、东南亚和西太平洋地区的患者中可能会带来特殊的挑战。在这些地区，环境因素、遗传背景和医疗保健的可及性与北美和西欧有很大的不同，多发性硬化症在这些地区最为常见。此外，多发性硬化症的诊断标准主要是使用来自北美和西欧的数据制定的。尽管无论在何处，一些被误诊为多发性硬化症的疾病都很常见，但在拉丁美洲、非洲、中东、东欧、东南亚和西太平洋地区进行多发性硬化症的全面鉴别诊断需要特别考虑那些在这些地区流行的疾病。因此，一项合作评估了多发性硬化症鉴别诊断的全球差异，并提出了在北美和西欧以外地区评估疑似多发性硬化症患者的建议。
