6533b829fe1ef96bd1289a63

RESEARCH PRODUCT

Defining the course of tumefactive multiple sclerosis: A large retrospective multicentre study

Lorenzo GaetaniDoriana LandiDiana FerraroPaolo RagoneseAlberto GajofattoCaterina Di CarminePaola CavallaMaria Pia AmatoEleonora Cocco 2Roberta Lanzillo 2Alessia ManniRoberta FantozziClaudio GasperiniD. FarinaGiuseppe FenuSara ZagagliaRaffaella CerquaClaudio SolaroAntonio GalloCarolina Gabri NicolettiPietro IaffaldanoFederica PinardiValentina Torri ClericiIsabella RighiniFabio ButtariDamiano PaolicelliPietro AnnovazziCarla TortorellaRocco TotaroGiovanna De Luca 2Chiara De FinoValentina TomassiniLuca ProsperiniMarcello MocciaViviana NocitiMaria Chiara BuscarinuMaria Di GregorioMassimiliano Di Filippo

subject

Maletumefactive demyelinating lesions (TDLs)0302 clinical medicineRetrospective StudieInterquartile rangedifferential diagnosis030212 general & internal medicineProspective StudiesYoung adultProspective cohort studyChildtreatmentTumefactive multiple sclerosiTumefactive demyelinating lesionsDemyelinating DiseaseMiddle AgedMagnetic Resonance ImagingDifferential diagnosis Multiple sclerosis Tumefactive demyelinating lesions Tumefactive multiple sclerosisNeurologydifferential diagnosis; Multiple sclerosis; Tumefactive demyelinating lesions; Tumefactive multiple sclerosisFemaleHumanAdultmedicine.medical_specialtyMultiple SclerosisAdolescentdifferential diagnosiSettore MED/26Multiple sclerosis03 medical and health sciencesYoung AdultTumefactive multiple sclerosisOligoclonal BandInternal medicinemedicineHumansMultiple sclerosiTumefactive multiple sclerosisTumefactive multiple sclerosis (TuMS)AgedRetrospective StudiesTumefactive demyelinating lesionExpanded Disability Status Scalebusiness.industryOligoclonal BandsRetrospective cohort studyOdds ratiomedicine.diseaseConfidence intervalProspective Studiedifferential diagnosis; Multiple sclerosis; Tumefactive demyelinating lesions; Tumefactive multiple sclerosis; Adolescent; Adult; Aged; Child; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Oligoclonal Bands; Prospective Studies; Retrospective Studies; Young Adult; Demyelinating Diseases; Multiple SclerosisprognosisNeurology (clinical)business030217 neurology & neurosurgeryDemyelinating Diseases

description

Background and purpose: Tumefactive multiple sclerosis (TuMS) (i.e., MS onset presenting with tumefactive demyelinating lesions [TDLs]) is a diagnostic and therapeutic challenge. We performed a multicentre retrospective study to describe the clinical characteristics and the prognostic factors of TuMS. Methods: One hundred two TuMS patients were included in this retrospective study. Demographic, clinical, magnetic resonance imaging (MRI), laboratory data and treatment choices were collected. Results: TuMS was found to affect women more than men (female:male: 2.4), with a young adulthood onset (median age: 29.5 years, range: 11–68 years, interquartile range [IQR]: 38 years). At onset, 52% of TuMS patients presented with the involvement of more than one functional system and 24.5% of them with multiple TDLs. TDLs most frequently presented with an infiltrative MRI pattern (38.7%). Cerebrospinal fluid immunoglobulin G oligoclonal bands were often demonstrated (76.6%). In 25.3% of the cases, more than one acute-phase treatment was administered, and almost one-half of the patients (46.6%) were treated with high-efficacy treatments. After a median follow-up of 2.3 years (range: 0.1–10.7 years, IQR: 3.4 years), the median Expanded Disability Status Scale (EDSS) score was 1.5 (range: 0–7, IQR: 2). Independent risk factors for reaching an EDSS score ≥3 were a higher age at onset (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.03–1.14, p < 0.01), a higher number of TDLs (OR: 1.67, 95% CI: 1.02–2.74, p < 0.05) and the presence of infiltrative TDLs (OR: 3.34, 95% CI: 1.18–9.5, p < 0.001) at baseline. Conclusions: The management of TuMS might be challenging because of its peculiar characteristics. Large prospective studies could help to define the clinical characteristics and the best treatment algorithms for people with TuMS.

yearjournalcountryeditionlanguage
2021-01-01
10.1111/ene.14672http://hdl.handle.net/11573/1565365