Descriptive Epidemiology of Pediatric Autoimmune Diseases of the Central Nervous System in the Afro-Descendant Population of the Caribbean Island of Martinique.

内容摘要

The epidemiology of primary autoimmune diseases of the central nervous system is poorly described in Caribbean and Afro-descendant children. We studied the incidence, clinical and biological characteristics, immunological profiles, and prognosis of these diseases in Martinique. We conducted a descriptive, retrospective, monocentric, population-based study from January 2010 to July 2024 including all children aged 0-17 years hospitalized for autoimmune encephalitis, multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD), or myelin oligodendrocyte glycoprotein-associated disease (MOGAD) in the pediatric units of the Martinique University Hospital. The sequelae were assessed using an Expanded Disability Status Scale score. Twenty-five children were hospitalized for primary autoimmune disease of the CNS in Martinique and 16% were admitted to intensive care. The median age at onset was 14 years (2-17 years). The incidence rates found were 0.34 per 100,000 person-years (95% confidence interval 0.09-0.88) for NMOSD and 0.52 per 100,000 person-years (0.19-1.13) for MOGAD, and 0.60 per 100,000 person-years (0.24-1.24) for multiple sclerosis. The immunological profile of NMOSD/MOGAD was 70% seropositive (4 aquaporin-4 and 3 myelin oligodendrocyte glycoprotein). First-line treatment was high-dose corticosteroid therapy in most cases (88%). Long-term sequelae were rare in our population and mortality was null. Our study showed an increase in the incidence of NMOSD diseases compared to international studies and no significant difference in the incidence rates of the other autoimmune disorders of the CNS in children. Outcomes were comparable to European and North American countries in our population. The immunological profile showed a high proportion of anti-aquaporin-4 antibodies compared to the literature.