Clinical characteristics of late ⁃ onset and very late ⁃ onset neuromyelitis optica spectrum disorders

Abstract

Objective To summarize the clinical features, treatment options and prognosis of late⁃onset and very late⁃onset neuromyelitis optica spectrum disorders (LO⁃NMOSDs and VLO⁃NMOSDs). Methods Total 68 patients with NMOSDs admitted to Beijing Tongren Hospital, Capital Medical University from January 2015 to December 2021 were included, while 55 with LO⁃NMOSDs and 13 with VLO⁃NMOSDs. The sex, first⁃onset symptoms, Extended Disability Status Scale (EDSS), complications, anti⁃aquaporin 4 (AQP4) antibody and autoimmune antibody, imaging examinations (optic nerve and spinal cord), therapeutic schedule and prognosis were compared between 2 groups. Results Compared with LO⁃NMOSDs group, VLO⁃NMOSDs group had higher EDSS scores at nadir (Z=⁃2.119, P=0.034), but there were no significant differences in sex, first⁃onset symptoms, combination with other autoimmune diseases or tumors, anti⁃AQP4 antibody and autoimmune antibody, optic nerve and spinal cord involvement sites, therapeutic schedule and EDSS scores within 14 d after acute treatment (P＞0.05, for all). Conclusions Patients with VLO⁃NMOSDs and LO⁃NMOSDs have similar demographic characteristics, clinical characteristics, therapeutic schedule and short⁃term prognosis, but the VLO⁃NMOSDs has more severe disability at nadir, and its long⁃term prognosis remains to be further explored.

doi：10.3969/j.issn.1672⁃6731.2022.09.003