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Diagnosis of Rapidly Progressive Dementia in a Referral Center in Argentina.
Alzheimer Disease & Associated Disorders ( IF 2.1 ) Pub Date : 2019-08-30 , DOI: 10.1097/wad.0000000000000337
Julián N Acosta 1 , Mario E Ricciardi 1 , Lucas Alessandro 1 , Martin Carnevale 2 , Mauricio F Farez 3 , Vanesa Nagel 1 , Ricardo F Allegri 4 , Francisco Varela 1
Affiliation  

INTRODUCTION Rapidly progressive dementia (RPD) is a broadly defined clinical syndrome. Our aim was to describe clinical and ancillary study findings in patients with RPD and evaluate their diagnostic performance for the identification of nonchronic neurodegenerative rapidly progressive dementia (ncnRPD). METHODS We reviewed clinical records and ancillary methods of patients evaluated for RPD at our institution in Buenos Aires, Argentina from 2011 to 2017. We compared findings between chronic neurodegenerative RPD and ncnRPD and evaluated the diagnostic metrics using receiver operating characteristic curves. RESULTS We included 104 patients with RPD, 29 of whom were chronic neurodegenerative RPD and 75 of whom were ncnRPD. The 6-month time to dementia cutpoint had a sensitivity of 89% and specificity of 100% for ncnRPD, with an area under the receiver operating characteristic curve of 0.965 (95% confidence interval=0.935-0.99; P<0.001). A decision tree that included time to dementia, brain magnetic resonance imaging, and cerebrospinal fluid analysis identified ncnRPD patients with a sensitivity of 100%, specificity of 79%, positive predictive value of 93%, and negative predictive value of 100% overall. DISCUSSION RPD is a clinical syndrome that comprises different diagnoses, many of them for treatable diseases. Using the time to dementia, brain magnetic resonance imaging, and cerebrospinal fluid analysis when triaging these patients could help identify those diseases that need to be studied more aggressively.

中文翻译:

阿根廷转诊中心的快速进展性痴呆的诊断。

引言快速进行性痴呆(RPD)是一种广泛定义的临床综合征。我们的目的是描述RPD患者的临床和辅助研究结果,并评估其诊断非慢性神经退行性快速进行性痴呆(ncnRPD)的诊断性能。方法我们回顾了2011年至2017年在阿根廷布宜诺斯艾利斯的本机构进行RPD评估的患者的临床记录和辅助方法。我们比较了慢性神经退行性RPD和ncnRPD的发现,并使用接收器操作特征曲线评估了诊断指标。结果我们纳入了104例RPD患者,其中29例为慢性神经退行性RPD,其中75例为ncnRPD。6个月的痴呆临界点对ncnRPD的敏感性为89%,特异性为100%,接收器工作特性曲线下的面积为0.965(95%置信区间= 0.935-0.99; P <0.001)。包括痴呆时间,脑磁共振成像和脑脊液分析在内的决策树确定了ncnRPD患者,其敏感性为100%,特异性为79%,阳性预测值为93%,阴性预测值为总体100%。讨论RPD是一种临床综合征,包括不同的诊断,其中许多诊断为可治疗的疾病。在对这些患者进行分类时,利用痴呆症的时间,脑磁共振成像和脑脊液分析可以帮助识别那些需要更积极研究的疾病。脑磁共振成像和脑脊液分析确定ncnRPD患者的总体敏感性为100%,特异性为79%,阳性预测值为93%,阴性预测值为100%。讨论RPD是一种临床综合征,包括不同的诊断,其中许多诊断为可治疗的疾病。在对这些患者进行分类时,使用痴呆症的时间,脑磁共振成像和脑脊液分析可以帮助识别那些需要更积极研究的疾病。脑磁共振成像和脑脊液分析确定ncnRPD患者的总体敏感性为100%,特异性为79%,阳性预测值为93%,阴性预测值为100%。讨论RPD是一种临床综合征,包括不同的诊断,其中许多诊断为可治疗的疾病。在对这些患者进行分类时,使用痴呆症的时间,脑磁共振成像和脑脊液分析可以帮助识别那些需要更积极研究的疾病。其中许多用于治疗疾病。在对这些患者进行分类时,使用痴呆症的时间,脑磁共振成像和脑脊液分析可以帮助识别那些需要更积极研究的疾病。其中许多用于治疗疾病。在对这些患者进行分类时,使用痴呆症的时间,脑磁共振成像和脑脊液分析可以帮助识别那些需要更积极研究的疾病。
更新日期:2019-11-01
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