Abstract Details

Title Neuromyelitis Optica Spectrum Disorder in a Tertiary Hospital in the Philippines: A Case Series

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-010

Objective NA

Background Neuromyelitis optica (NMO) spectrum disorder (NMOSD) is a rare disease that commonly presents with optic nerve and spinal cord inflammation, and it is associated with the presence of aquaporin-4 immunoglobulin G antibody (AQP4-IgG). Information on the clinical profile and occurrence of NMOSD among Filipino patients, however, is not sufficiently documented in the literature.

Design/Methods Case series

Results In this series, we presented eighteen (18) patients with NMOSD consecutively seen in the Philippine General Hospital, a major tertiary referral center. The diagnosis of NMOSD was made in accordance with the criteria published by the International Panel of NMO Diagnosis in 2015. Demographic data showed a female-to-male ratio of 2.6:1. Median age of onset of symptoms was 26 years (range 12 to 47). Eight patients (53.3%) were positive for AQP4-IgG. Most patients initially presented with myelitis (56.6%) and followed by optic neuritis (16.7%) and area postrema syndrome (16.7%). All patients had longitudinally extensive transverse myelitis on spinal magnetic resonance imaging (MRI). Cranial MRI rarely demonstrated lesions in the optic nerves (18.2%). Occurrence of cerebrospinal fluid pleocytosis (33%) and increased protein (8.3%) among the patients included were infrequent. Visual evoked responses were abnormal in 7 out of 12 patients (58.3%). All patients who underwent brainstem auditory evoked response test had normal findings. Five patients (10 eyes) had thin retinal nerve fiber layer thickness in the optical coherence tomography.

Conclusions

These results showed that the profile of Filipino patients with NMOSD seen in our institution strengthens those described in other populations with this disorder. Large scale cross-sectional studies are necessary to fully define the profile of these patients and to determine with accuracy the prevalence and incidence of this disorder in the Philippines. Further investigation regarding the utility of ancillary tests as diagnostic and prognostic indicators in patients with NMOSD are also suggested by the authors.

Authors/Disclosures
Adrian I. Espiritu, MD (Ontario Shores Centre for Mental Health Sciences) PRESENTER	Dr. Espiritu has nothing to disclose.
	No disclosure on file
	No disclosure on file
Nikolai Gil D. Reyes, MD (University of Toronto - Toronto Western Hospital)	Dr. Reyes has nothing to disclose.
	No disclosure on file
	No disclosure on file

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