Sistema de Salut de Catalunya
Institut Català de la Salut
[Makhani N] Department of Pediatrics, Yale University School of Medicine, USA. Department of Neurology, Yale University School of Medicine, USA. [Lebrun C] CRCSEP Nice Hopital Pasteur, Nice, France. [Siva A] University of Istanbul, Istanbul, Turkey. Cerrahpasa School of Medicine, Istanbul, Turkey. [Narula S] Children's Hospital of Philadelphia, Philadelphia, USA. University of Pennsylvania, Philadelphia, USA. [Wassmer E] Department of Neurology, The Birmingham Children's Hospital NHS Trust, Birmingham, UK. [Brassat D] Centre Hospitalo Universitaire Purpan, Toulouse, France. [Tintoré M] Centre d'Esclerosi Múltiple de Catalunya, Barcelona, Spain.
Vall d'Hebron Barcelona Hospital Campus
2019-05-08T10:07:31Z
2019-05-08T10:07:31Z
2019-03-20
Radiologically isolated syndrome; Children; Multiple sclerosis
Síndrome radiològicament aïllat; Nens; Esclerosi múltiple
Síndrome radiológicamente aislado; Niños; Esclerosis múltiple
BACKGROUND: Steps towards the development of diagnostic criteria are needed for children with the radiologically isolated syndrome to identify children at risk of clinical demyelination. OBJECTIVES: To evaluate the 2005 and 2016 MAGNIMS magnetic resonance imaging criteria for dissemination in space for multiple sclerosis, both alone and with oligoclonal bands in cerebrospinal fluid added, as predictors of a first clinical event consistent with central nervous system demyelination in children with radiologically isolated syndrome. METHODS: We analysed an international historical cohort of 61 children with radiologically isolated syndrome (≤18 years), defined using the 2010 magnetic resonance imaging dissemination in space criteria (Ped-RIS) who were followed longitudinally (mean 4.2 ± 4.7 years). All index scans also met the 2017 magnetic resonance imaging dissemination in space criteria. RESULTS: Diagnostic indices (95% confidence intervals) for the 2005 dissemination in space criteria, with and without oligoclonal bands, were: sensitivity 66.7% (38.4-88.2%) versus 72.7% (49.8-89.3%); specificity 83.3% (58.6-96.4%) versus 53.9% (37.2-69.9%). For the 2016 MAGNIMS dissemination in space criteria diagnostic indices were: sensitivity 76.5% (50.1-93.2%) versus 100% (84.6-100%); specificity 72.7% (49.8-89.3%) versus 25.6% (13.0-42.1%). CONCLUSIONS: Oligoclonal bands increased the specificity of magnetic resonance imaging criteria in children with Ped-RIS. Clinicians should consider testing cerebrospinal fluid to improve diagnostic certainty. There is rationale to include cerebrospinal fluid analysis for biomarkers including oligoclonal bands in planned prospective studies to develop optimal diagnostic criteria for radiologically isolated syndrome in children
Article
Published version
English
Esclerosi múltiple - Imatgeria; Immunoglobulines; Infants; Adolescents; DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Oligoclonal Bands; NAMED GROUPS::Persons::Age Groups::Child; NAMED GROUPS::Persons::Age Groups::Adolescent; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen; COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::bandas oligoclonales; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adolescente
SAGE Publications
Multiple Sclerosis Journal - Experimental, Translational and Clinical;5(1)
https://journals.sagepub.com/doi/10.1177/2055217319836664
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
