Clinical, laboratory features, and prognostic factors in adult acute transverse myelitis

an Italian multicenter study

Pasquale Annunziata, Gianni Masi, Chiara Cioni, Matteo Gastaldi, Enrico Marchioni, Emanuele D’amico, Francesco Patti, Alice Laroni, Gianluigi Mancardi, Francesca Vitetta, Patrizia Sola

Research output: Contribution to journalArticle

Abstract

Objectives: We compared the clinical, laboratory, and radiological features of different subgroups of acute transverse myelitis (ATM) diagnosed according to the criteria established by the Transverse Myelitis Consortium Working Group (TMCWG) as well as of non-inflammatory acute transverse myelopathies (NIATM) to identify possible short- and long-term prognostic factors. Methods: A multicenter and retrospective study comprising 110 patients with ATM and 15 NIATM admitted to five Italian neurological units between January 2010 and December 2014 was carried out. Results: A significantly higher frequency of isolated sensory disturbances at onset in ATM than in NIATM patients (chi-square = 14. 7; P = 0.005) and a significantly higher frequency of motor symptoms in NIATM than ATM (chi-square = 12.4; P = 0.014) was found. ATM patients with high disability at discharge had more motor-sensory symptoms without (OR = 3.87; P = 0.04) and with sphincter dysfunction at onset (OR = 7.4; P = 0.0009) compared to those with low disability. Higher age (OR = 1.08; P = 0.001) and motor-sensory-sphincter involvement at onset (OR = 9.52; P = 0.002) were significantly associated with a high disability score at discharge and after a median 1-year follow-up. Conclusions: The diagnosis of ATM may prevail respect to that of NIATM when a sensory symptomatology at onset occurs. In ATM, patients older and with motor-sensory involvement with or without sphincter impairment at admission could experience a major risk of poor prognosis both at discharge and at longer time requiring a timely and more appropriate treatment.

Original languageEnglish
JournalNeurological Sciences
DOIs
Publication statusPublished - Jan 1 2019

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Transverse Myelitis
Multicenter Studies
Spinal Cord Diseases
Retrospective Studies

Keywords

  • Connective autoimmune disorders
  • Disability
  • Multiple sclerosis
  • Neuromyelitis optica spectrum disorders
  • Prognosis
  • Transverse myelitis

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Clinical, laboratory features, and prognostic factors in adult acute transverse myelitis : an Italian multicenter study. / Annunziata, Pasquale; Masi, Gianni; Cioni, Chiara; Gastaldi, Matteo; Marchioni, Enrico; D’amico, Emanuele; Patti, Francesco; Laroni, Alice; Mancardi, Gianluigi; Vitetta, Francesca; Sola, Patrizia.

In: Neurological Sciences, 01.01.2019.

Research output: Contribution to journalArticle

Annunziata, Pasquale ; Masi, Gianni ; Cioni, Chiara ; Gastaldi, Matteo ; Marchioni, Enrico ; D’amico, Emanuele ; Patti, Francesco ; Laroni, Alice ; Mancardi, Gianluigi ; Vitetta, Francesca ; Sola, Patrizia. / Clinical, laboratory features, and prognostic factors in adult acute transverse myelitis : an Italian multicenter study. In: Neurological Sciences. 2019.
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abstract = "Objectives: We compared the clinical, laboratory, and radiological features of different subgroups of acute transverse myelitis (ATM) diagnosed according to the criteria established by the Transverse Myelitis Consortium Working Group (TMCWG) as well as of non-inflammatory acute transverse myelopathies (NIATM) to identify possible short- and long-term prognostic factors. Methods: A multicenter and retrospective study comprising 110 patients with ATM and 15 NIATM admitted to five Italian neurological units between January 2010 and December 2014 was carried out. Results: A significantly higher frequency of isolated sensory disturbances at onset in ATM than in NIATM patients (chi-square = 14. 7; P = 0.005) and a significantly higher frequency of motor symptoms in NIATM than ATM (chi-square = 12.4; P = 0.014) was found. ATM patients with high disability at discharge had more motor-sensory symptoms without (OR = 3.87; P = 0.04) and with sphincter dysfunction at onset (OR = 7.4; P = 0.0009) compared to those with low disability. Higher age (OR = 1.08; P = 0.001) and motor-sensory-sphincter involvement at onset (OR = 9.52; P = 0.002) were significantly associated with a high disability score at discharge and after a median 1-year follow-up. Conclusions: The diagnosis of ATM may prevail respect to that of NIATM when a sensory symptomatology at onset occurs. In ATM, patients older and with motor-sensory involvement with or without sphincter impairment at admission could experience a major risk of poor prognosis both at discharge and at longer time requiring a timely and more appropriate treatment.",
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T1 - Clinical, laboratory features, and prognostic factors in adult acute transverse myelitis

T2 - an Italian multicenter study

AU - Annunziata, Pasquale

AU - Masi, Gianni

AU - Cioni, Chiara

AU - Gastaldi, Matteo

AU - Marchioni, Enrico

AU - D’amico, Emanuele

AU - Patti, Francesco

AU - Laroni, Alice

AU - Mancardi, Gianluigi

AU - Vitetta, Francesca

AU - Sola, Patrizia

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: We compared the clinical, laboratory, and radiological features of different subgroups of acute transverse myelitis (ATM) diagnosed according to the criteria established by the Transverse Myelitis Consortium Working Group (TMCWG) as well as of non-inflammatory acute transverse myelopathies (NIATM) to identify possible short- and long-term prognostic factors. Methods: A multicenter and retrospective study comprising 110 patients with ATM and 15 NIATM admitted to five Italian neurological units between January 2010 and December 2014 was carried out. Results: A significantly higher frequency of isolated sensory disturbances at onset in ATM than in NIATM patients (chi-square = 14. 7; P = 0.005) and a significantly higher frequency of motor symptoms in NIATM than ATM (chi-square = 12.4; P = 0.014) was found. ATM patients with high disability at discharge had more motor-sensory symptoms without (OR = 3.87; P = 0.04) and with sphincter dysfunction at onset (OR = 7.4; P = 0.0009) compared to those with low disability. Higher age (OR = 1.08; P = 0.001) and motor-sensory-sphincter involvement at onset (OR = 9.52; P = 0.002) were significantly associated with a high disability score at discharge and after a median 1-year follow-up. Conclusions: The diagnosis of ATM may prevail respect to that of NIATM when a sensory symptomatology at onset occurs. In ATM, patients older and with motor-sensory involvement with or without sphincter impairment at admission could experience a major risk of poor prognosis both at discharge and at longer time requiring a timely and more appropriate treatment.

AB - Objectives: We compared the clinical, laboratory, and radiological features of different subgroups of acute transverse myelitis (ATM) diagnosed according to the criteria established by the Transverse Myelitis Consortium Working Group (TMCWG) as well as of non-inflammatory acute transverse myelopathies (NIATM) to identify possible short- and long-term prognostic factors. Methods: A multicenter and retrospective study comprising 110 patients with ATM and 15 NIATM admitted to five Italian neurological units between January 2010 and December 2014 was carried out. Results: A significantly higher frequency of isolated sensory disturbances at onset in ATM than in NIATM patients (chi-square = 14. 7; P = 0.005) and a significantly higher frequency of motor symptoms in NIATM than ATM (chi-square = 12.4; P = 0.014) was found. ATM patients with high disability at discharge had more motor-sensory symptoms without (OR = 3.87; P = 0.04) and with sphincter dysfunction at onset (OR = 7.4; P = 0.0009) compared to those with low disability. Higher age (OR = 1.08; P = 0.001) and motor-sensory-sphincter involvement at onset (OR = 9.52; P = 0.002) were significantly associated with a high disability score at discharge and after a median 1-year follow-up. Conclusions: The diagnosis of ATM may prevail respect to that of NIATM when a sensory symptomatology at onset occurs. In ATM, patients older and with motor-sensory involvement with or without sphincter impairment at admission could experience a major risk of poor prognosis both at discharge and at longer time requiring a timely and more appropriate treatment.

KW - Connective autoimmune disorders

KW - Disability

KW - Multiple sclerosis

KW - Neuromyelitis optica spectrum disorders

KW - Prognosis

KW - Transverse myelitis

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