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Retrospective, descriptive study of acute myelitis in French Guyana

P Grimont1, A Montcuquet2, F Quet3

  • 1Département de neurologie, centre hospitalier de Cayenne, Cayenne, Guyane, France.

Revue Neurologique
|February 1, 2025
PubMed
Abstract

Insights

Autoimmune causes, particularly neuromyelitis optica spectrum disorder (NMOSD), are the most frequent reason for acute myelitis in French Guyana. This study highlights a high prevalence of NMOSD, suggesting a need to consider immune-related etiologies in this region.

Area of Science:

  • Neurology
  • Immunology
  • Epidemiology

Background:

  • Acute myelitis presents diagnostic challenges, with infectious and autoimmune causes being primary considerations.
  • French Guyana faces diverse infectious etiologies and emerging autoimmune diseases.
  • Understanding the etiological landscape of acute myelitis in French Guyana is crucial.

Purpose of the Study:

  • To determine the proportion of infectious versus autoimmune etiologies in acute myelitis cases in French Guyana.
  • To characterize the clinical, paraclinical, and epidemiological features of autoimmune myelitis, focusing on neuromyelitis optica spectrum disorder (NMOSD).

Main Methods:

  • Retrospective observational study of acute myelitis patients from January 2015 to August 2023.
  • Chart review for etiological classification, demographic, and clinical data collection.
  • Analysis of blood, cerebrospinal fluid, and MRI findings.

Main Results:

  • Autoimmune etiology accounted for 74% of acute myelitis cases, with NMOSD comprising 49%.
  • Prevalence of NMOSD in French Guyana estimated at 8/100,000, with 37% testing positive for anti-aquaporin-4 antibodies.
  • Infectious etiologies were less common, observed in only three patients.

Conclusions:

  • Autoimmune causes, especially NMOSD, are highly prevalent in acute myelitis cases in French Guyana.
  • The high NMOSD prevalence in French Guyana is the second highest globally.
  • Genetic and environmental factors may contribute to the high rate of autoimmune myelitis, necessitating consideration of NMOSD in differential diagnoses.
Keywords:
Acute myelitisAutoimmunityFrench GuianaNeuromyelitis optica spectrum disorder (NMOSD)

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