Longitudinally extensive transverse myelitis immune-mediated in aquaporin-4 antibody negative patients: Disease heterogeneity
| Autor: | Alejandra Gomez, Javier Pablo Hryb, Sergio Morales, José Luis Di Pace, Edson Chiganer, Edgar Carnero Contentti, Carmen Lessa, Mónica Perassolo |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Pathology Myelitis Myelitis Transverse Gastroenterology Severity of Illness Index Transverse myelitis 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine Severity of illness medicine Humans Optic neuritis Autoantibodies Retrospective Studies Aquaporin 4 Neuromyelitis optica medicine.diagnostic_test business.industry Multiple sclerosis Neuromyelitis Optica Brain Magnetic resonance imaging medicine.disease 030104 developmental biology Neurology Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of the neurological sciences. 373 |
| ISSN: | 1878-5883 |
| Popis: | Background Longitudinally extensive transverse myelitis (LETM) is a frequent manifestation of neuromyelitis optica spectrum disorder (NMOSD). However, it can also occur in other immune-mediated diseases of the central nervous system (CNS). Positive aquoporin-4 antibodies (AQP4-ab) predict higher relapse rate after LETM. Objective To assess clinical and brain/spinal cord magnetic resonance imaging (MRI) features of LETM immune-mediated at onset and to compare AQP4-ab negative (N-LETM) with AQP4-ab positive (P-LETM) patients. Methods Thirty LETM patients remitted for consideration of inflammatory CNS diseases were included. Demographics, clinical, serological, disability and neuroimaging features at onset we reviewed retrospectively and divided into two groups according to serological status. AQP4-ab were tested using indirect immunofluorescence. Results Twenty-one patients were N-LETM. We did not find significant differences between both groups as regards gender, age at onset, dysfunction (motor, sensory, bladder/bowel) or disability. However, recurrences ( p = 0.04) of myelitis and number of relapses ( p = 0.03) were associated to P-LETM. N-LETM was associated with normal brain MRI ( p = 0.04) at onset. AQP4-ab positive were only observed in NMOSD patients. N-LETM (24%) and P-LETM (56%) patients had relapses of optic neuritis (ON) during the follow-up. Conclusion LETM at onset is a heterogeneous syndrome with similar clinical and neuroimaging features between both groups. N-LETM displayed a lower relapse rate of myelitis and ON. |
| Databáze: | OpenAIRE |
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