Male patients with neuromyelitis optica spectrum disorders: different clinical characteristics and worse steroid treatme
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ORIGINAL ARTICLE
Male patients with neuromyelitis optica spectrum disorders: different clinical characteristics and worse steroid treatment response Rui Li 1 & Cong Li 1 & Zhifeng Mao 2 & Qiao Huang 3 & Yaqing Shu 1 & Yanyu Chang 1 & Jingqi Wang 1 & Yuge Wang 1 & Wei Qiu 1 Received: 30 July 2020 / Accepted: 20 November 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Clinical data on male neuromyelitis optica spectrum (NMO) patients remain limited to date. Objective To analyze clinical characteristics, therapeutic responses, and outcomes in Chinese male NMOSD patients. Methods We retrospectively assessed clinical, demographic, treatment, and outcome data of male patients with NMOSD. Results We identified 52 male patients among 471 NMOSD patients. Male patients had more frequent optic neuritis (ON) attacks and less frequent myelitis than female patients. No-remission rates of high-dose intravenous steroid therapy were higher in male patients than in female patients. Conclusion Male NMOSD patients had different clinical characteristics and worse response to high-dose intravenous steroid therapy than female patients. Keywords Neuromyelitis optica spectrum disorders . Sex . Steroid treatment . Clinical characteristics
Introduction Neuromyelitis optica (NMO) is a prototypic central nervous system (CNS) autoimmune disease that primarily involves the optic nerves and the spinal cord [1]. NMO spectrum disorder (NMOSD) exhibits a significant female preponderance; male NMOSD patients, who account for only 10–20% of all patients with NMOSD, are rare [2–7], and the clinical characteristics of previous NMOSD case series primarily reflect that of the female patients. Only a few studies showed that sex affected the clinical characteristics of NMOSD. Male patients with NMOSD had a higher age of onset, lower aquaporin 4-IgG (AQP4-IgG) seropositivity rate, more frequent myelitis (MY), and less optic neuritis (ON) [3, 4, 8]. However, these results
derived from relatively small sample studies and needed to be confirmed by a larger male NMOSD series. In addition, it remains unclear whether sex affects the treatment response and prognosis of NMOSD. Therefore, we conducted this retrospective study with a larger sample size to analyze the clinical characteristics, therapeutic responses, and outcomes in Chinese male patients with NMOSD. This study will help increase our understanding of the disease pathogenesis and guide appropriate individual treatment.
Methods Standard protocol approvals, registrations, and patient consent
Rui Li and Cong Li contributed equally to this work. * Wei Qiu [email protected]; [email protected] 1
Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
2
KingMed College of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
3
The Second People’s Hospital of Zhaoqing, Zhaoqing, China
The Ethics Committee of the Third Affilia
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