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视神经脊髓炎谱系障碍(NMOSD)的诊断与治疗进展——波兰神经病学学会多发性硬化与神经免疫学分会的建议

Update on diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) - recommendations of Section of Multiple Sclerosis and Neuroimmunology of Polish Neurological Society.

作者信息

Zakrzewska-Pniewska Beata, Bartosik-Psujek Halina, Brola Waldemar, Gołębiowski Marek, Kalinowska Alicja, Kułakowska Alina, Mirowska-Guzel Dagmara, Nojszewska Monika, Podlecka-Piętowska Aleksandra, Stasiołek Mariusz, Wawrzyniak Sławomir, Adamczyk-Sowa Monika

机构信息

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland.

出版信息

Neurol Neurochir Pol. 2025;59(1):6-19. doi: 10.5603/pjnns.100945. Epub 2024 Dec 18.

Abstract

INTRODUCTION

An expert panel of the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society has developed principles for the management of neuromyelitis optica spectrum disorders (NMOSD). These principles are based on expert opinion and data from the literature published up to May 2023. Recommendations were developed based on the results of the most recent clinical trials, guidelines of foreign and international scientific societies, and the authors' clinical experience.

CLINICAL IMPLICATIONS

The principles for diagnosing NMOSD are discussed, with particular emphasis on serological and neuroimaging diagnosis. Recommendations for the treatment of relapses and chronic immunosuppressive treatment, including the most recent methods of immunotherapy, are also presented. Additionally, the principles of monitoring treatment efficacy and safety are included. Therapy regimens are completed with recommendations for symptomatic treatment. The paper also includes an algorithm for vaccination in patients with NMOSD. Therapeutic management in pregnant women with NMOSD is discussed.

摘要

引言

波兰神经病学学会多发性硬化症与神经免疫学分会的一个专家小组制定了视神经脊髓炎谱系障碍(NMOSD)的管理原则。这些原则基于专家意见以及截至2023年5月发表的文献数据。建议是根据最新临床试验结果、国外和国际科学学会的指南以及作者的临床经验制定的。

临床意义

讨论了NMOSD的诊断原则,特别强调血清学和神经影像学诊断。还提出了复发治疗和慢性免疫抑制治疗的建议,包括最新的免疫治疗方法。此外,还包括监测治疗效果和安全性的原则。治疗方案还补充了对症治疗的建议。本文还包括NMOSD患者的疫苗接种算法。讨论了NMOSD孕妇的治疗管理。

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