Abstract Details

Title Clinical Course of LETM Associated with Neuroschistosomiasis

Topic Infections/AIDS/Prion Disease

Presentation(s) P03 - (-)

Poster/Presentation
Number 253

Objective

Background BACKGROUND: LETM, a propagate subset of spinal cord (SC) inflammation, has broad differential diagnosis, including spectrum of neuromyelitis optica (NMOSD) and infections. Proper diagnosis is of utmost importance due a critical role of therapeutic approach. LETM may occur as a manifestation of neuroschistossomiasis in his clinicar course is fairly studied. Schistosomiasis, which prevalence is around 200 million worldwide, representing a clue diagnosis in a globalized world, where borders no longer restrict diseases and pathogens.

Design/Methods DESIGN/METHODS: Prospective follow-up of patients from a cohort of LETM that fulfilled definite diagnosis of NS (DNS): schistosoma eggs is found in SC biopsy ; probable NS (PrNS), if presence of low thoracic or lumbar SC involvement, positive epidemiology plus demonstration of schistosomal infection, and possible NS (PoNS), when only low thoracic or lumbar SC lesion and positive epidemiology were present. Exclusion criteria were: systemic disease associated with LETM and seropositivity to NMO-IgG.

Results RESULTS: 16 consecutive patients with LETM, fulfilled diagnostic criteria to DNS(1), PrNS (9) or PoNS (6). 11 were male (68%) and all of them non-caucasian. Mean age :30.9 (range 17-51). Median time of follow-up: 3.5 years (range 0.5-6). MRI showed thoracic lesion (5), thoraco-lombar (8) and entire spinal cord lesion (2). Cerebro-spinal fluid demonstrated median 61,1 celll/mm3 (range 1-320) and 72,1 protein (range 27-254). Median extension of lesion:10,5 vertebral segments (range 10 to 22). 4 patients (25%) experienced corticosteroid-dependent relapse.

Conclusions CONCLUSIONS: LETM associated with NS may evolve with recurrence. We are not able to affirm if recurrent LETM represent propagate inflammation secondary to egg deposits or a sera-negative spectrum of NMO. Restrict criteria are necessary to distinguish infectious LETM of NMOSD. It is possible that parasite infection deflagrates an immune-mediated inflammatory cascade, justifying the corticosteroids dependent state in our patiens.

Authors/Disclosures
Samira Apostolos-Pereira (Hospital Das Clinicas College of Medicine Sao Paulo University) PRESENTER	Samira Apostolos-Pereira has nothing to disclose.
	No disclosure on file
	No disclosure on file
Jose A. Livramento, MD, PhD (Lab.Spina Franca)	No disclosure on file
Dagoberto Callegaro, PhD	No disclosure on file
	No disclosure on file
Florian Then Bergh, MD (University of Leipzig, Klinik u. Poliklinik fuer Neurologie)	Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Actelion. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Fresenius. Dr. Then Bergh has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. The institution of Dr. Then Bergh has received research support from Actelion. The institution of Dr. Then Bergh has received research support from Novartis. The institution of Dr. Then Bergh has received research support from DFG (German Science Fund). The institution of Dr. Then Bergh has received research support from Fresenius. The institution of Dr. Then Bergh has received research support from Diamed. Dr. Then Bergh has received personal compensation in the range of $10,000-$49,999 for serving as a Member of the Institutional Ethics Board with University of Leipzig, Medical Faculty.

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