揭露错误诊断:重新思考血清阴性NMOSD
Mary V Lang1, Grant M Welk1, Deena A Tajfirouz2,3
1Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
诊断血清阴性神经炎光学谱系障碍 (NMOSD) 是很困难的. 这项研究发现2015年标准经常被误用,许多患者有多发性硬化症等替代诊断.
科学领域:
- 神经免疫学 神经免疫学
- 神经学 神经学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 血清阴性神经炎光学谱系障碍 (NMOSD) 提出了诊断方面的挑战.
- 准确的诊断对于适当的治疗和管理至关重要.
- 2015年的国际标准旨在标准化NMOSD诊断.
研究的目的:
- 评估2015年针对血清阴性NMOSD的国际标准的应用.
- 在疑似血清阴性NMOSD病例中识别诊断标准的错误应用.
- 确定转诊为血清阴性NMOSD患者的替代诊断的频率.
主要方法:
- 对35次连续的血清阴性NMOSD转诊的回顾性审查.
- 评估遵守2015年国际诊断标准的情况.
- 基于临床和放射学发现的替代诊断分析.
主要成果:
- 只有6%的患者符合2015年血清阴性NMOSD的正式标准.
- 另有6%的人在临床上怀疑,但缺乏放射性支持.
- 常见的替代诊断包括多发性硬化症 (37%),视神经炎 (14%),功能神经障碍 (11%).
结论:
- 滥用2015年针对血清阴性NMOSD的标准是普遍存在的.
- 替代诊断是常见的,应该强烈考虑.
- 需要仔细评估,以避免在血清阴性NMOSD转诊中误诊.
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