Disparities in Multiple Sclerosis Mimickers in a Diverse Population of Urban Patients
Konstantin Balashov1, Alexandra Rubenstein1
1Department of Neurology, Boston Medical Center and Boston University School or Medicine
Objective:
To identify disparities in patients with multiple sclerosis (MS) mimics in a diverse urban population.
Background:
Our institution was ranked among the top five most racially inclusive hospitals in the US in 2021 and 2022. This allows us to analyze health disparities among racially and ethnically diverse populations of patients diagnosed with MS and disorders that mimic MS. To our knowledge, health disparities among patients wrongly suspected of having MS have yet to be studied.
Design/Methods:
We conducted a retrospective chart analysis of 129 patients suspected to have MS and referred to our MS center for evaluation. Our analysis included patients’ demographic, clinical and laboratory/imaging data. Graphpad Prism software was used for statistical analysis.
Results:
Out of 129 patients suspected to have MS, most of them identified themselves as Black (44%), White (28%), and Hispanic (17%). Based on 2017 McDonald diagnostic criteria, MS was not confirmed in 56 patients (43%), further referred to as MS mimics. A higher proportion of White patients were diagnosed with MS mimics than Non-white patients (P=0.031, Chi-square test).
The most common MS mimics were nonspecific demyelinating disease (NDD, 9 patients), MOG antibody disease (MOGAD, 7 patients), and Tuberculosis (TB, 6 patients). A TB diagnosis was statistically more prevalent among Black than White non-MS patients (P=0.026).
14% of patients whom we diagnosed with MS mimics were treated with disease modifying therapies (DMTs) prior to their visit in our center. Non-English speakers were disproportionately represented in this group (14% of non-English vs 5% of English speakers, not statistically significant).
Conclusions:
The prevalence of MS mimics is very high in a diverse urban population of patients suspected to have MS. NDD, MOGAD, and TB are the most prevalent MS mimics. Many of these patients were treated with DMTs prior to visit in our center. TB was disproportionally diagnosed among Black non-MS patients.