Assuntos
Antagonistas dos Receptores CCR5/uso terapêutico , Linfócitos T CD8-Positivos/metabolismo , Cicloexanos/uso terapêutico , Síndrome Inflamatória da Reconstituição Imune/tratamento farmacológico , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Receptores CCR5/biossíntese , Triazóis/uso terapêutico , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Humanos , Síndrome Inflamatória da Reconstituição Imune/metabolismo , Leucoencefalopatia Multifocal Progressiva/imunologia , Leucoencefalopatia Multifocal Progressiva/metabolismo , Maraviroc , Microscopia Confocal , Receptores CCR5/análiseAssuntos
Cloridrato de Fingolimode/uso terapêutico , Fatores Imunológicos/efeitos adversos , Imunossupressores/uso terapêutico , Leucoencefalopatia Multifocal Progressiva/induzido quimicamente , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Esclerose Múltipla Recidivante-Remitente/complicações , Natalizumab/efeitos adversos , Adulto , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Vírus JC , Masculino , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Natalizumab/uso terapêuticoRESUMO
OBJECTIVES: To identify prognostic factors associated with poor visual recovery and chronic relapsing diseases, for example, multiple sclerosis (MS), in children with optic neuritis (ON) at onset. METHODS: This multicentre retrospective study included 102 children with a first ON episode between 1990 and 2012. The primary criterion was poor visual recovery determined by visual acuity, and the secondary was relapses following ON. RESULTS: Median age was 11 years, 66% were girls and mean follow-up was 24 months. 58% of children were diagnosed with idiopathic isolated ON, 22% had MS, 5% had Devic's neuromyelitis optica and 6% chronic relapsing inflammatory ON. Complete visual acuity recovery rate was 57% (95% CI=[46%-69%]) at 6 months and 71% (95% CI=[60%-81%]) at 1 and 2 years but was lower in MS (p<0.01), with recovery rate of only 27% (95% CI=[12%-54%]) at 1 year. Age ≥10 years, optic disc pallor at funduscopy and MS were the principal factors associated with poor visual recovery. Age ≥10 years, abnormal brain MRI at onset and oligoclonal banding were significantly associated with MS (p<0.01). CONCLUSION: Age ≥10, optic disc pallor and MS were associated with poor recovery. Better identification of these patients may help to adapt treatment and lead to a prospective treatment study.