University of Southern California (USC), Keck School of Medicine, Department of Neurology, Los Angeles, CA, USA.
Division of Neurology, Department of Medicine, University of Toronto, ON, Canada; St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Lancet Neurol. 2024 Oct;23(10):1050-1062. doi: 10.1016/S1474-4422(24)00288-6.
The differential diagnosis of suspected multiple sclerosis has been developed using data from North America, northern Europe, and Australasia, with a focus on White populations. People from minority ethnic and racial backgrounds in regions where prevalence of multiple sclerosis is high are more often negatively affected by social determinants of health, compared with White people in these regions. A better understanding of changing demographics, the clinical characteristics of people from minority ethnic or racial backgrounds, and the social challenges they face might facilitate equitable clinical approaches when considering a diagnosis of multiple sclerosis. Neuromyelitis optica, systemic lupus erythematous, neurosarcoidosis, infections, and cerebrovascular conditions (eg, hypertension) should be considered in the differential diagnosis of multiple sclerosis for people from minority ethnic and racial backgrounds in North America, northern Europe, and Australasia. The diagnosis of multiple sclerosis in people from a minority ethnic or racial background in these regions requires a comprehensive approach that considers the complex interplay of immigration, diagnostic inequity, and social determinants of health.
对疑似多发性硬化症的鉴别诊断是基于北美、北欧和澳大拉西亚的数据制定的，重点关注白种人群。多发性硬化症高发地区的少数族裔和少数种族背景的人群在健康的社会决定因素方面受到的负面影响往往比这些地区的白种人更大。更好地了解人口结构的变化、少数族裔或少数种族背景人群的临床特征以及他们所面临的社会挑战，可能有助于在考虑多发性硬化症的诊断时采取公平的临床方法。对于来自北美的北美、北欧和澳大拉西亚的少数族裔和少数种族背景的人群，应考虑视神经脊髓炎、系统性红斑狼疮、神经结节病、感染和脑血管疾病（如高血压）在多发性硬化症的鉴别诊断中。在这些地区，对于少数族裔或少数种族背景的人群，多发性硬化症的诊断需要一种全面的方法，考虑到移民、诊断不公平和健康的社会决定因素的复杂相互作用。
