Causas no inflamatorias de consulta urgente en esclerosis múltiple Article Swipe

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Luís Antônio , I. García Castañón , M.J. Aguilar-Amat Prior , Inmaculada Puertas , Inés González‐Suarez , C. Oreja Guevara · YOU? · · 2018 · Open Access · · DOI: https://doi.org/10.1016/j.nrl.2018.02.006

Describir consultas urgentes de pacientes con esclerosis múltiple (EM) distintas a brotes: causas, dificultades diagnósticas, características clínicas y tratamientos empleados. Estudio retrospectivo de los pacientes que acudieron a un Hospital de Día de EM en 2 años por sospecha de brote y que recibieron un diagnóstico alternativo. Se evaluaron variables demográficas, características clínicas de los pacientes, diagnósticos finales y tratamientos. Los pacientes con diagnóstico final de brote e inicialmente diagnosticados de pseudobrote se evaluaron específicamente. Con una finalidad exploratoria se compararon las características de los pacientes que consultaban por causas no inflamatorias con una cohorte de pacientes aleatoriamente seleccionados que habían sufrido un brote en el mismo periodo de tiempo. Se incluyeron un total de 50 pacientes inicialmente diagnosticados de pseudobrotes (33 mujeres, con edad media 41,4 ± 11,7 años). Cuatro pacientes (8% del total) fueron inicialmente diagnosticados de pseudobrote aunque posteriormente fueron diagnosticados de un verdadero brote. La fiebre y el vértigo fueron los principales factores de confusión. Las causas no inflamatorias de consulta urgente fueron: neurológicas: 43,5% (20); infecciosas: 15,2% (7); psiquiátricas: 10,9% (5); vértigo: 8,6% (4); traumatológicas: 10,9% (5), y otras: 10,9% (5). La mayor parte de las consultas urgentes no inflamatorias fueron causadas por síntomas relacionados con la EM. El seguimiento estrecho de brotes y pseudobrotes es necesario para detectar diagnósticos incorrectos, evitar tratamientos innecesarios y aliviar los síntomas de los pacientes. To describe non-relapse-related emergency consultations of patients with multiple sclerosis (MS): causes, difficulties in the diagnosis, clinical characteristics, and treatments administered. We performed a retrospective study of patients who attended a multiple sclerosis day hospital due to suspected relapse and received an alternative diagnosis, over a 2-year period. Demographic data, clinical characteristics, final diagnosis, and treatments administered were evaluated. Patients who were initially diagnosed with pseudo-relapse and ultimately diagnosed with true relapse were evaluated specifically. As an exploratory analysis, patients who consulted with non-inflammatory causes were compared with a randomly selected cohort of patients with true relapses who attended the centre in the same period. The study included 50 patients (33 were women; mean age 41.4 ± 11.7 years). Four patients (8%) were initially diagnosed with pseudo-relapse and later diagnosed as having a true relapse. Fever and vertigo were the main confounding factors. The non-inflammatory causes of emergency consultation were: neurological, 43.5% (20 patients); infectious, 15.2% (7); psychiatric, 10.9% (5); vertigo, 8.6% (4); trauma, 10.9% (5); and miscellaneous, 10.9% (5). MS-related symptoms constituted the most frequent cause of non-inflammatory emergency consultations. Close follow-up of relapse and pseudo-relapse is necessary to detect incorrect initial diagnoses, avoid unnecessary treatments, and relieve patients' symptoms.

Type

article

Language

es

Landing Page

https://doi.org/10.1016/j.nrl.2018.02.006

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gold

Cited By

5

References

34

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10

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https://openalex.org/W2803369801

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OpenAlex ID

https://openalex.org/W2803369801

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DOI

https://doi.org/10.1016/j.nrl.2018.02.006

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Title

Causas no inflamatorias de consulta urgente en esclerosis múltiple

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Type

article

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Language

es

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Publication year

2018

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Publication date

2018-05-26

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Authors

Luís Antônio, I. García Castañón, M.J. Aguilar-Amat Prior, Inmaculada Puertas, Inés González‐Suarez, C. Oreja Guevara

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https://doi.org/10.1016/j.nrl.2018.02.006

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Yes

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gold

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https://doi.org/10.1016/j.nrl.2018.02.006

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Medicine, Humanities, Gynecology, Art

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Cited by

5

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2024: 2, 2023: 1, 2022: 2

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34

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10

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