A multi-facet comparative analysis of neuromyelitis optica spectrum disorders in patients with seropositive and seronegative AQP4-IgG

Medicine (Baltimore). 2018 Nov;97(48):e13100. doi: 10.1097/MD.0000000000013100.

Abstract

Introduction: Neuromyelitis optica spectrum disorders (NMOSD), a rare, serious, demyelinating disease of the central nervous system (CNS), is associated with immunoglobulin G (IgG) antibodies targeting aquaporin-4 (AQP4-IgG). This study retrospectively analyzed the clinical features of 67 patients. 49 and 18 of 67 cases (male/female: 11/56) were AQP4-IgG (+) and AQP4-IgG (-), respectively. The initial symptoms were optic neuritis [n = 34, AQP4-IgG (+)/(-): 31/3], myelitis [n = 18, AQP4-IgG(+)/(-): 13/5], co-occurrence of ON and myelitis [n = 15, AQP4-IgG (+)/(-): 5/10].

Conclusions: There was no statistically significant difference between the 2 groups in terms of ages, and magnetic resonance imaging findings, but the patients had a significant difference (P <.05) in sex, the course of disease and Expanded Disability Status Scale (EDSS) scores after drug treatment. Patients with AQP4-IgG (-) are likely to have a better prognosis and a favorable monophasic course.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aquaporin 4 / immunology*
  • Autoantibodies
  • Comorbidity
  • Disability Evaluation
  • Female
  • Humans
  • Immunoglobulin G / immunology*
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Neuromyelitis Optica / drug therapy
  • Neuromyelitis Optica / immunology*
  • Neuromyelitis Optica / physiopathology
  • Neuroprotective Agents / therapeutic use
  • Retrospective Studies
  • Sex Factors
  • Young Adult

Substances

  • Aquaporin 4
  • Autoantibodies
  • Immunoglobulin G
  • Neuroprotective Agents
  • Methylprednisolone