Multiple sclerosis-like NMOSD patients suffer severe worsening of status after fingolimod initiation

Background Initial clinical manifestations of NMOSD may rarely overlap with MS. Fingolimod trigger severe attacks in patients previously misdiagnosed as These cases are rare and their pathophysiology remains elusive. Methods We recruited all treated by fingolimod a single-center cohort Afro-Caribbean neuro-inflammatory Fort-de-France (French West Indies). Six were collected from the literature. Results Among 622 followed locally for MS, 101 received two suffered revealing typical presentation. found to have AQP4-IgG. The risk MS our high-risk was estimated be 1.9% (0 4.7%). whole cohort, relapses occurred within month after initiation five patients. All contrasted benign attacks, suggesting shift more disorder. An unusual finding these large brain lesions. Conclusion AQP4-IgG should obtained before patients, especially those areas high prevalence.