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Neuromyelitis optica‐IgG in idiopathic inflammatory demyelinating disorders amongst Hong Kong Chinese
Author(s) -
Chan K. H.,
Ramsden D. B.,
Yu Y. L.,
Kwok K. H. H.,
Chu A. C. Y.,
Ho P. W. L.,
Kwan J. S. C.,
Lee R.,
Lim E.,
Kung M. H. W.,
Ho S. L.
Publication year - 2009
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2008.02376.x
Subject(s) - neuromyelitis optica , medicine , transverse myelitis , optic neuritis , myelitis , multiple sclerosis , demyelinating disorder , spinal cord , aquaporin 4 , autoantibody , demyelinating disease , pathology , immunology , antibody , psychiatry
Background: Idiopathic inflammatory demyelinating disorders (IIDD) affect the central nervous system. In classical multiple sclerosis (CMS), brain, optic nerves [optic neuritis (ON)] and spinal cord [acute transverse myelitis (ATM)] are affected. In neuromyelitis optica (NMO), optic nerves and spinal cord are predominantly affected. NMO‐IgG, an autoantibody targeting aquaporin‐4, is a marker for NMO. We studied the frequency and clinical relevance of NMO‐IgG seropositivity in IIDD patients. Methods: Neuromyelitis optica‐IgG was detected by indirect immunofluorescence using primate cerebellum. Results: Neuromyelitis optica‐IgG was detected in six of 10 NMO patients (60%), six of 10 idiopathic relapsing transverse myelitis (IRTM) patients (60%), two of nine idiopathic relapsing ON patients (22%), one of 11 patients (9%) having single ON attack, one of 30 CMS patients (3%), and none of patients having single ATM attack or controls. Comparing NMO‐IgG seropositive ( n = 12) with NMO‐IgG seronegative ( n = 8) patients having NMO or IRTM, NMO‐IgG seropositivity was associated with a higher relapse rate in first 2 years, 1.5 and 0.6 attacks/year for seropositive and seronegative groups respectively ( P = 0.006), and non‐significant trend towards more severe ON and myelitis with poorer clinical outcome. Conclusion: Neuromyelitis optica ‐IgG facilitates diagnosis of NMO spectrum disorders. NMO‐IgG seropositivity is associated with higher relapse rate in first 2 years.