Browsing by Author "Tkachuk, Veronica"

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    Diagnostic MRI Score to Differentiate Susac Syndrome from Primary Angiitis of the Central Nervous System and Multiple Sclerosis
    (2024) Marrodan, Mariano; Calandri, Ismael L.; Bocancea, Diana I.; Ysrraelit, Maria C.; Figueroa, Enrique Gomez; Paez, Montserrat Masso; Flores, Jose D. J.; Rojas, Juan I.; Ciampi, Ethel; Ioli, Pablo; Zanga, Gisela; Ardohain, Carolina; Fracaro, Maria E.; Amaya, Mariela; Tkachuk, Veronica; Fernandez, Victoria C.; Jose, Gustavo; Silva, Emanuel; Luetic, Geraldine; Contentti, Edgar Carnero; Kohler, Eduardo; Cassara, Fatima Pagani; Moran, Dolores; Seimandi, Carla; Paviolo, Juan P.; D'elio, Brenda; Da Prat, Gustavo; Gatto, Emilia; Cristiano, Edgardo; Lereis, Virginia Pujol; Ameriso, Sebastian F.; Fiol, Marcela P.; Correale, Jorge
    Objective: Susac syndrome (SuS), multiple sclerosis (MS), and primary angiitis of the central nervous system (PACNS) present diagnostic challenges due to overlapping clinical features. We aimed to enhance diagnostic precision by developing the SPAMS (SuS, PACNS, MS) score, a practical radiological tool. Methods: This multicenter study included 99 patients (43 SuS, 37 MS, 19 PACNS) from South American countries. Relevant MRI features were identified through an elastic-net model determined key variables. Results: The SPAMS score assigned 2 points for snowball lesions, 1 point for spokes-like lesions, or if there are more than 4 lesions in the corpus callosum, corpus callosum involvement, or cerebellar involvement. It subtracted 1 point if gadolinium-enhancing lesions or 4 points if Dawson's fingers are present. Bootstrapping validated the optimal cutoff at 2 points, exhibiting a diagnostic performance of area under the curve = 0.931, sensitivity = 88%, specificity = 89%, positive predictive value = 88%, negative predictive value = 89%, and accuracy = 88%. Interpretation: When specific MRI findings coexisted, the SPAMS score differentiated SuS from MS and PACNS. Access to MRI and standard protocol sequences makes it a valuable tool for timely diagnosis and treatment, potentially preventing disability progression and severe clinical outcomes.
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    The real-world applicability of the 2023 international myelin oligodendrocyte glycoprotein antibody-associated disease criteria in a Latin American cohort
    (2024) Contentti, Edgar Carnero; Pestchanker, Claudia; Ciampi, Ethel; Suarez, Sheila Castro; Zamalloa, Cesar Caparo; Marques, Vanesa Daccach; Messias, Katharina; Gortari, Jose Ignacio; Tkachuk, Veronica; Silva, Berenice; Mainella, Carolina; Reyes, Saul; Toro, Jaime; Rodriguez, Juan; Correa-Diaz, Edgar; Rojas, Juan I.; Paul, Friedemann
    Background and Purpose: The diagnostic criteria for myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease (MOGAD) were published in 2023. We aimed to determine the performance of the new criteria in Latin American (LATAM) patients compared with the 2018 criteria and explore the significance of MOG-IgG titers in diagnosis. Methods: We retrospectively reviewed the medical records of LATAM (Argentina, Chile, Brazil, Peru, Ecuador, and Colombia) adult patients with one clinical MOGAD event and MOG-IgG positivity confirmed by cell-based assay. Both 2018 and 2023 MOGAD criteria were applied, calculating diagnostic performance indicators. Results: Among 171 patients (predominantly females, mean age at first attack = 34.1 years, mean disease duration = 4.5 years), 98.2% patients met the 2018 criteria, and of those who did not fulfill diagnostic criteria (n = 3), all tested positive for MOG-IgG (one low-positive and two without reported titer). Additionally, 144 (84.2%) patients met the 2023 criteria, of whom 57 (39.5%) had MOG-IgG+ titer information (19 clearly positive and 38 low-positive), whereas 87 (60.5%) patients had no MOG-IgG titer. All 144 patients met diagnostic supporting criteria. The remaining 27 patients did not meet the 2023 MOGAD criteria due to low MOG-IgG (n = 12) or lack of titer antibody access (n = 15), associated with the absence of supporting criteria. The 2023 MOGAD criteria showed a sensitivity of 86% (95% confidence interval = 0.80-0.91) and specificity of 100% compared to the 2018 criteria. Conclusions: These findings support the diagnostic utility of the 2023 MOGAD criteria in an LATAM cohort in real-world practice, despite limited access to MOG-IgG titration.