WIP 83 - Pediatric Neuroimmunological Diseases: Demographic Factors Impacting Diagnosis and Treatment at a Pediatric Tertiary/Quaternary Medical Center

Publication Number: WIP 83.7714

Grace Kim, CHOC Children's Hospital of Orange County, Orange, CA, United States; Sophia Falmagne, CHOC Children's Hospital of Orange County, Orange, CA, United States; Janetta L. Arellano, CHOC Children's Hospital of Orange County, Orange, CA, United States

Background: Pediatric neuroimmunology is a growing field, with recent identification of specific biomarkers to aid in diagnosis. These disorders have the potential for significant impact on development, as well as considerable financial and caregiver burden. Additionally, a common feature of pediatric neuroimmunological diseases (ND) is that immunotherapeutic agents can alter the clinical course of the disease. Thus, timely diagnosis prior to treatment is essential to improve outcomes. There is limited literature regarding these conditions in relation to socioeconomic factors.

Objective: To investigate socioeconomic factors in a diverse patient population that contribute to delayed diagnosis and treatment of pediatric ND.

Design/Methods: This is a single-center retrospective review of pediatric patients who presented to a tertiary/quaternary children’s hospital with ND from 2015-2022. Institutional IRB approval was obtained to query the electronic medical records for the ICD-10 codes for the following conditions: multiple sclerosis, acute disseminated encephalomyelitis, myelin oligodendrocyte glycoprotein antibody disease, neuromyelitis optica spectrum disorder, clinically isolated syndrome, autoimmune encephalitis, acute flaccid myelitis, acute/chronic inflammatory demyelinating polyneuropathy.

There were 814 patient charts identified. The following descriptive and clinical features were collected: sex, race, ethnicity, gender, age, zip code, language, time to evaluation and treatment, laboratory results, diagnostics, treatment, and relapses. Upon initial analysis of partial data, there were 80 patient charts identified as meeting the following inclusion criteria: age at initial presentation (birth-21 years), confirmed diagnosis of a neuroimmune condition, and workup and treatment primarily at the institution. Our full dataset will be submitted to our statistician by the end of 2024 for analysis to characterize pediatric ND and identify demographic factors that may impact the length of time to diagnosis and treatment.