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Epidemiology of pediatric multiple sclerosis, neuromyelitis optica, and optic neuritis in Taiwan
Wei-Sheng Lin1, Hsin-Pei Wang2, Ho-Min Chen3
1Department of Pediatrics, National Taiwan University Hospital Yunlin branch, No.579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 640, Taiwan. wshenq@yahoo.com.tw.
Insights
The incidence of pediatric multiple sclerosis (MS) in Taiwan remained stable, while neuromyelitis optica (NMO) cases increased significantly, suggesting improved diagnosis. Autoimmune comorbidities were rare in these pediatric demyelinating disorders.
Area of Science:
- Neurology
- Epidemiology
- Pediatric Disorders
Background:
- Epidemiology of pediatric acquired demyelinating disorders is not well-defined in Asia.
- This study focuses on pediatric multiple sclerosis (MS), neuromyelitis optica (NMO), and optic neuritis (ON) in Taiwan.
Purpose of the Study:
- To describe the epidemiology of pediatric MS, NMO, and ON in Taiwan.
- To investigate demographic features and comorbidities of these conditions.
Main Methods:
- Retrospective nationwide population-based study using Taiwan's National Health Insurance Research Database.
- Identified prevalent cases (2001-2015) and incident cases (2003-2015) of pediatric MS and NMO, and incident cases of ON.
- Analyzed demographic data and comorbidities.
Main Results:
- Identified 403 MS, 42 NMO, and 1496 ON incident cases (under 20 years) from 2003-2015.
- MS and ON incidence were stable; NMO incidence increased significantly, especially later in the study period.
- Female predominance observed in pediatric MS and NMO; autoimmune comorbidities were uncommon.
Conclusions:
- Pediatric MS epidemiology in Taiwan was stable (2001-2015), while pediatric NMO prevalence rose steeply, likely due to enhanced recognition.
- Autoimmune comorbidities were infrequent in pediatric MS and NMO cases in Taiwan.
Background And Objective:
The epidemiology of pediatric acquired demyelinating disorders remains to be clarified in many parts of Asia. We carry out this study to depict the epidemiology of pediatric multiple sclerosis (MS), neuromyelitis optica (NMO), and optic neuritis (ON) in Taiwan.
Methods:
We conducted a retrospective nationwide population-based study using data from Taiwan's National Health Insurance Research Database. Prevalent cases of pediatric MS and NMO during 2001-2015, and incident cases of pediatric MS, NMO, and ON during 2003-2015 were identified. The demographic features and comorbidities were investigated.
Results:
We identified 403 MS, 42 NMO, and 1496 ON incident cases under the age of 20 during 2003-2015. The majority of pediatric MS (86.1%) and NMO (90.5%) patients were 10 years old or above. The incidence of MS and ON was relatively steady, while that of NMO increased prominently later during the study period. The average incidence of pediatric MS and NMO during 2011-2015 was 0.52 and 0.11 per 100,000 person-years, respectively. The female preponderance was evident for pediatric MS and NMO, and less so for pediatric ON. The most common autoimmune comorbidities for pediatric MS were thyrotoxicosis (1.0%) and systemic lupus erythematosus (0.7%).
Conclusion:
The epidemiology of pediatric MS was largely stationary in Taiwan during 2001-2015, while the prevalence of pediatric NMO rose steeply during this period, probably reflecting better recognition of this clinical entity. Autoimmune comorbidities were uncommon for pediatric MS and NMO in Taiwan.
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