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NMOSD can co-occur with other autoimmune conditions. This study compared clinical characteristics and treatment responses in NMOSD patients with and without co-occurring autoimmune conditions and identified predictors for each in a primarily Black cohort.

Among patients with neuromyelitis optica spectrum disorder (NMOSD), the co-occurrence of other autoimmune diseases results in worse clinical outcomes and higher healthcare costs when compared to NMOSD alone. Additionally, NMOSD and other autoimmune conditions have a higher prevalence and morbidity among Black Americans. This study, published in the Journal of the Neurological Sciences, compares clinical features and treatment responses in patients with NMOSD with and without other autoimmune conditions in a primarily Black cohort. The authors then identify predictors for each clinical subtype. The study used data from 27 patients with NMOSD, and 14 patients with NMOSD and another autoimmune condition.

The cohort for this study was 82.9% Black. Grouped comorbidities, history of infections, sensory symptoms, double-stranded DNA, white matter occipital lesions, and several other metrics were higher in the group that had an additional autoimmune condition. Other factors, such as visual symptoms, serum albumin, platelet count, and optic nerve enhancement were lower. Expanded Disability Status Scale (EDSS) score after treatment was improved in both groups, but the improvement was greater in the group without additional autoimmune issues. 

Other variables had a close or moderate standard error, and some did not differ between NMOSD subtypes. The authors also found that a higher frequency of grouped comorbidities, lower serum albumin, and platelet count were independently associated with a higher risk for additional autoimmune conditions and NMOSD. This demographic information and details about comorbidities can be used to inform treatment options and testing needs for patients that fall into this primarily Black cohort. 

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Reference:

Alvarez, M. R., Gurung, A., Velayndhan, V., Cuascut, F., Alkabie, S., Freeman, L., Phayal, G., Kabani, N., Pathiparampil, J., Bhamra, M., Kreps, A., Koci, K., Francis, S., Zhaz Leon, S. Y., Levinson, J., Lezcano, M. R., Amarnani, A., Xie, S., Valsamis, H., . . . McFarlane, I. M. (2022). Predictors of overlapping autoimmune disease in Neuromyelitis Optica Spectrum disorder (NMOSD): A retrospective analysis in two inner-city hospitals. J Neurol Sci, 443, 120460. https://doi.org/10.1016/j.jns.2022.120460