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A recent study found that up to 18% of multiple sclerosis (MS) diagnoses could be incorrect. Migraine was the most commonly false disease with MS in the sample studied.
Multiple sclerosis, an autoimmune disease that affects the nervous system, is not an easy entity to diagnose. Tell them dozens of patients who spend years before receiving a definitive diagnosis.
Many symptoms of MS are also present in other diseasesfor example, in migraine, lupus or peripheral neuropathy, one of the factors contributing to the difficulty of diagnosis and finally to the appearance of erroneous diagnoses.
Recently published research in the magazine Multiple sclerosis and related disorders found that almost one in five patients had been admitted to two specialized neurology clinics With an established diagnosis of MS, I did not really have the disease.
In most cases, this meant receiving drugs specific to MS, drugs that can cause serious side effects such as progressive multifocal leukoencephalopathy (PML), a life-threatening disease.
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More than 200 patients with multiple sclerosis and 43 others were not
The researchers' goal was to identify cases of incorrect diagnosis of MS among all those admitted (for one year) with an established diagnosis of MS in two specialized clinics, one at the University of California at Los Angeles ( UCLA) and another. at Cedars-Sinai Medical Center (both located in the United States).
The previous goal was joined by identify common features among the cases of misdiagnosis that may help prevent these situations in the future.
The final sample consisted of 241 peoplealthough five were excluded by finally receiving a diagnosis of isolated clinical syndrome (ACS), a disorder that may or may not progress to an established diagnosis of MS.
In the last sample, 112 patients had attended the Cedars-Sinai Medical Center and Of these, 19 (17%) ended up receiving a different diagnosis than MS..
In the case of people treated at UCLA, 126 out of 24 (19%) patients had received an incorrect initial diagnosis.
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The most common correct diagnoses
The study also describes the correct diagnosis ultimately received by patients initially diagnosed with MS.
First there is migraine, a condition that in some cases can cause brain damage which, when collected using neuroimaging techniques, is similar to that of the brain. detected in people with MS.
A migraine follows:
- Isolated radiological syndrome
- spondylopathies
- neuropathy
In some cases, depending on what the researchers have said, there were clear indicators to doubt a diagnosis of MSeven so, this has been done. They comment:
"A particularly troubling result was that 6 (14%) of the patients diagnosed with error had normal brain and spinal cord images and that a group other than 6 (14%) had undergone a normal neurological examination; both characteristics should be used with caution when diagnosing MS. "
Aggressive treatment for a disease that did not exist
The researchers explain that "the incorrect diagnosis of MS in this study was badociated with considerable risk for the patient and a huge cost to health".
Average patients they were 4 years old living with a bad diagnosis. It highlights the case of a man who was in this situation 20 years.
The unnecessary use of drugs such as disease modifiers, which, depending on the case, may have a complex safety profile, puts the health of patients at risk.
According to researchers' calculations, only drugs could have been spent unnecessarily near $ 10 million.
In the words of one of the authors of the study, Dr. Marwa Kaisey:
I have seen patients suffer side effects from the medications that they were taking because of an illness that they did not have. In the meantime, they did not receive treatment for what they had. The cost to the patient is enormous, from a medical, psychological and financial point of view. "
From the point of view of the professionals, the reliability of the current diagnostic criteria and the need for further research on the objective markers of the disease are underlined.
It is important to put the data in context
Although the information provided by this study may surprise more than one (and justify the reasons), it is necessary take into account the place where the survey was conducted and be cautious in extrapolating the findings to other countries.
The American health system has its particularities, very different from those of a public health system such as Spanish, for example, and the results can not be generalized.
In the same way, the study is a call in the field of MS to a complex problem that often does not receive the attention it deserves.
You might also be interested in reading: Multiple Sclerosis Therapies: Reduce Risk or Bet on Effectiveness
The sources
Chiara Townley (2019): A study shows that many people with MS do not have this disease. In https://www.medicalnewstoday.com/articles/325008.php
Kaisey, Marwa et al. (2019): Incidence of Misdiagnosis of Multiple Sclerosis in Referrals to Two Academic Centers. Multiple sclerosis and related disorders, volume 30, 51 – 56. In https://www.msard-journal.com/article/S2211-0348(19)30048-3/fulltext
About the author
Dunia Chappotin
Psychologist, Master in Psychogerontology and founder of TiTi. If I do not write, I read. There is a third option: it can be lost somewhere because I am very distraught.
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