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Epidemiology of pediatric multiple sclerosis, neuromyelitis optica, and optic neuritis in Taiwan

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Abstract

Background and objective

The epidemiology of pediatric acquired demyelinating disorders remains to be clarified in many parts of Asia. We carry out this study to depict the epidemiology of pediatric multiple sclerosis (MS), neuromyelitis optica (NMO), and optic neuritis (ON) in Taiwan.

Methods

We conducted a retrospective nationwide population-based study using data from Taiwan’s National Health Insurance Research Database. Prevalent cases of pediatric MS and NMO during 2001–2015, and incident cases of pediatric MS, NMO, and ON during 2003–2015 were identified. The demographic features and comorbidities were investigated.

Results

We identified 403 MS, 42 NMO, and 1496 ON incident cases under the age of 20 during 2003–2015. The majority of pediatric MS (86.1%) and NMO (90.5%) patients were 10 years old or above. The incidence of MS and ON was relatively steady, while that of NMO increased prominently later during the study period. The average incidence of pediatric MS and NMO during 2011–2015 was 0.52 and 0.11 per 100,000 person-years, respectively. The female preponderance was evident for pediatric MS and NMO, and less so for pediatric ON. The most common autoimmune comorbidities for pediatric MS were thyrotoxicosis (1.0%) and systemic lupus erythematosus (0.7%).

Conclusion

The epidemiology of pediatric MS was largely stationary in Taiwan during 2001–2015, while the prevalence of pediatric NMO rose steeply during this period, probably reflecting better recognition of this clinical entity. Autoimmune comorbidities were uncommon for pediatric MS and NMO in Taiwan.

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Acknowledgements

This study was in part supported by grants from the Ministry of Science and Technology, Taiwan (MOST 107–2314-B-002–165), and National Taiwan University Hospital Yunlin Branch (NTUHYL106.A001). Taiwan Ministry of Science and Technology and National Taiwan University Hospital Yunlin Branch had no role in any of the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Pediatrics, National Taiwan University Hospital Yunlin branch, No.579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 640, Taiwan

    Wei-Sheng Lin & Hsin-Pei Wang

  2. Health Data Research Center, National Taiwan University, Taipei, Taiwan

    Ho-Min Chen

  3. Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Douliu City, Yunlin, Taiwan

    Jou-Wei Lin

  4. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan

    Wang-Tso Lee

  5. Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan

    Wang-Tso Lee

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  1. Wei-Sheng Lin
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Contributions

WSL, HMC, JWL, and WTL contributed to the study conception and design. Material preparation, data collection and analysis were performed by WSL, HPW and HMC. The first draft of the manuscript was written by WSL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Wei-Sheng Lin.

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The authors have no conflict of interest to report.

Ethical approval

The study was approved by the National Taiwan University Hospital Research Ethics Committee (201904028RINC).

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Lin, WS., Wang, HP., Chen, HM. et al. Epidemiology of pediatric multiple sclerosis, neuromyelitis optica, and optic neuritis in Taiwan. J Neurol 267, 925–932 (2020). https://doi.org/10.1007/s00415-019-09647-9

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  • DOI: https://doi.org/10.1007/s00415-019-09647-9

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